Billing Director

Oversee and supervises all aspects of the Billing and Collection functions/Department. Performs supervisory functions, implements, ensure that claims / invoices are submitted to the appropriate Payor sources in a complete, accurate, and timely manner. Post payments to the Payor accounts accurately and on a timely basis. Perform follow-up on accounts receivable and address any billing related questions/issues from Payors or patients.

1. Post payments received from all Payor sources daily. Ensure payments reconcile with deposit and daily batch prior to each daily close.

2. Interacts with other Departments, front-line staff and Payors to resolve account issues in a courteous fashion.

3. Monitor re-filed claims monthly to ensure proper payment is received.

4. Generate Un-applied Cash Report on a monthly basis. Correct account balances and submit refund request as appropriate with CFO?s approval.

5. Perform manual adjustments to accounts as directed by CFO.

6. Analyze patient account detail (charges, payments, adjustments) and answer detailed questions from Payors and third party Payors regarding claims or account status.

7. Assists in compiling monthly financial reports as deemed necessary.

8. The Billing Director is expected to establish and maintain effective working relationships with co-workers and function as a team player.

9. Works with Third Party Payors (Managed Care, Private Insurance, Self-Pay) daily to ensure timely collection of accounts receivable.

10. Maintain current knowledge of all third party reimbursement requirements. Keep Providers, and Staff informed regarding changes for all third- party billing in a timely manner.

11. Assist in the maintenance of contract profiles, insurance plans, and other support files.

12. Oversee training of billing staff and training on key issues.

13. Provide feedback on denials, coding issues, etc.

14. Oversee and monitor the implementation of the compliance program.

15. Establishing methods, such as periodic audits, to improve the organization?s efficiency and quality of services, and to reduce the vulnerability to fraud and abuse.

16. Periodically revise the compliance program in light of changes in the needs of the organization or changes in the law and in the policies and procedures of Medicare, Medicaid, and private Payor health plans.

17. Develops, coordinates and participates in a training program that focuses on the compliance program.

18. Ensures departmental staff and providers know and comply with pertinent Federal and State statutes, regulations, and standards.

19. Assist in Investigating any report or allegation concerning possible unethical or improper billing practices, and monitoring subsequent corrective action and /or compliance.

20. Participate in all billing and collection related meetings and training as requested by the CFO.

21. Ensure adequate communication links between front-end staff, back-end staff, providers and related managers (i.e., Provider Relations)

22. Allocate the time of all staff to ensure that all departmental tasks are performed in a cost-efficient manner.

23. Identifies missed revenue opportunities, suggest appropriate solutions and implements plans accordingly.



Bachelors? degree in Heath Care, Business Administration or related field with 5 years in billing and collection experience. Experienced in medical terminology, ICD-9-CM and CPT-4 codes required. Familiarity using billing and management software required. Contracts implementation experience is a must. Supervisory experience and manage multiple projects at one time. Should possess courteous and accurate communication skills.