SUMMARY: This position is responsible for the oversight, systems development, compliance, and performance of the Billing and Front Office Department and revenue cycle process. This role is expected to constantly improve workflow and overall function for departmental operations.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: other duties may be assigned:
Job Specific Duties –
- Responsible for supervision of all revenue related activities for Billing and Front Office Operations.
- Supervises Billing staff and shares supervision of Front Office staff. Responsible for selecting, orienting, training, coaching, disciplining, & giving timely performance reviews.
- Supervises Billing and Coding Coordinator and establishes billing and coding training plans.
- Develops workflows and protocols for Front Office and Billing Department and all revenue generating workflows including but not limited to insurance verification and registration and demographic accuracy.
- Directs coding initiatives for all TBCHS activity. Establishes plans for quality reporting, HCC coding, CPT/HCPCS, and diagnosis coding and ensures staff are functioning at maximum potential within scope of their role.
- Completes random chart analysis and provides provider revenue generation education in cooperation with the Chief Medical Officer.
- Establishes chart analysis review in conjunction with the peer review process.
- Provides provider coding training.
- Oversees revenue cycle process and develops workplans to ensure appropriate denial management and education. Monitors all billing statuses and claims management, meeting established days in receivables for each payor.
- Manages the configuration of all electronic billing systems to ensure proper functioning for effective and efficient billing and collection processes.
- Reviews and implements technology to leverage front office efficiency and enhanced reimbursement (i.e., registration kiosks, online bill pay, autopay, Practice Management System)
- Maintains fee schedules
- Manages Sliding Fee Program and ensures all staff are trained appropriately.
- Provides Executive Management requested reports on a timely basis.
- Establishes short- and long-term goals for respective departments, ensuring staffing levels meet organization needs.
- Ability to work independently.
- Collaborates with management and leadership staff to contribute to efficient and consistent workflow across all sites.
- Oversees day to day operations of site and promptly follows through on concerns identified.
- Processes departmental reports for tracking and review utilizing appropriate software systems.
- Assist in financial reporting such as UDS or Medicaid Reconciliation reporting as assigned.
- Remain aware of coding updates and Federal and State billing requirements.
- Remains current with reimbursement guidelines for all payors
- Participates in internal and external committees and workgroups appropriate to role.
SPECIALIZED SKILLS & KNOWLEDGE: Knowledge of state and federal laws pertaining to records management, including HIPAA regulations. Knowledge of practices and procedures used in effective records management and referrals. Familiarity with Electronic Medical Records (EMR). Knowledge of insurance (i.e. Medicare, Medicaid, Managed Care), including eligibility, interpretation, coding, documentation, billing, and auditing is preferred. Experience with medical software programs. Working knowledge of medical terminology and procedures.
SUPERVISORY RESPONSIBILITIES: Directly supervises the staff, processes and functions of the Billing Department.
EDUCATION and/or EXPERIENCE: 6-8 years related experience and relevant Bachelor’s degree. Accredited coding certification required.
PHYSICAL DEMANDS: Light
TRAVEL: Between sites and to conferences