Position: Medical Office Billing Director

Responsible To : COO

Department: Medical Billing

Summary: 

SUMMARY:

The Billing Director is responsible for revenue maximization for all assigned Camarena Health receivables. The Billing Director develops and maintains reports regarding accounts receivables and establishes and maintains reporting and departmental policies and procedures to ensure quality and effectiveness of work completed. Supervises Billing personnel and conveys information regarding performance to employees in a positive, constructive manner and ensure effective work habits. Assist in the establishment and implementation of annual operating and capital budget and departmental goals.

EXPECTATIONS:

  • Arrives on time and adheres to set schedule.
  • Maximize billing revenue cycle.
  •  Assist A/R Coordinators with any accounts receivable problems they may encounter.
  • Oversee billing review and timely submission.
  • Oversee inputting of Charges/ Payments/Adjustments for part of electronic Medi-Cal billing.
  • Be informed of new regulations from Medi-Cal, Medi-Care, etc. and work with A/R Coordinators in the implementation of changes.
  • Aging of all accounts are within Camarena targets.
  • Oversees staff working with patients with concerns on their accounts.
  • Instill and expect customer satisfaction (patients understand their charges and payment options).
  • Supports all Camarena Healthport computer users, solving problems, answering questions, and assisting as appropriate
  • Analyzes prioritizes, logs, forwards, and tracks resolution of all incoming Healthport request.
  • Interfaces with hardware and software vendors for product information, problems, and enhancements regarding Healthport.
  • Monitor and minimize account write offs
  • Maintains open communication with supervisor, team members, and all staff
  • The Department collects and records data accurately
  • Use of professionalism and best efforts in your position.

Duties and Responsibilities:

1.0 Focus on Oversight and Supervision of A/R Unit:

1.1 Supports Camarena financial position by managing an effective charge capturing system, payment and adjustment posting, and billing and collection program that lead toward achievement of goals.

1.2 Communicates regularly with COO on departmental activities and issues; and keeps Chief Operations Officer and Director of Finance informed of specific payor issues affecting reimbursement.

1.3 Manages the continued development of the unit by maintaining appropriate policies and procedures.

1.4 Support the team environment by maintaining a high level of motivation, dedication, professionalism and personal appearance for self and staff.

1.5 Supports Camarena financial position by resolving credit balances and making determinations for possible refunds.

1.6 Supports the goals of the team by identifying and correcting problems and ensures that adequate material and personnel resources are available.

1.7 Ensures quality work by reviewing staff work to ensure billing, collecting, follow-up and documentation standards are met.

1.8 Ensures sufficient internal controls to maintain integrity of all data processing activities and regular monitoring of third party reimbursement changes, denials and appeals, unbilled revenue, and credit balance issues.

1.9 Ensures that proper paperwork and approvals are maintained on administrative adjustment approvals, deposit waivers, uncompensated care approvals, bad debt
write-off approvals, refunds, denials, appeals, and certifications.

1.10 Initial approval of all refunds and adjustments. (Final approval by COO.)

2.0 Focus on Individual Performance:

2.1 Work collaboratively with employees throughout Camarena Health and outside agencies by demonstrative commitment to and knowledge of team goals.

2.2 Communicates effectively with team members, work out problems encountered and provide constructive suggestions to improve team performance.

3.0 Focus on Corporate Expectations/Standards:

3.1 Attends and actively participates in all meetings (e.g., team meetings, department meetings, program meetings, case management meetings, employee staff meetings) and other activities as required or assigned.

3.2 Attends workshops/seminars as necessary to increase skills and knowledge to provide effective support.

3.3 Works flexible or extended hours where necessary.

3.4 Demonstrates awareness of, and compliance with, organizational mission and objective of Camarena Health to provide health care access and support services for all members of the community.

3.5 Other work-related duties as assigned by supervisor; duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.

3.6 Maintains confidentiality and respect for information regarding patients and other team members; abides by Camarena Health Rules of Confidentiality

 

Minimum Requirements:

Education:

  • High School Diploma or GED with multi-year experience in program management (see experience)

Prior Experience:

· Minimum of two (3) years of health care related business experience. Preferably with working knowledge of specialty programs (e.g., CHDP, BCEDP, Medi-Cal).

· Extensive experience with Healthport and Dentrix

Skills:

· Bilingual (English-Spanish) preferred; Excellent oral and written skills.

· Telephone courtesy; customer-service oriented.

· Modern office practices and procedures including email.

· Intermediate to expert user computer skills.

· Highly organized.

· History and proven record of effective program/project management.

· Attention to detail and excellent follow-through on work tasks.

· Demonstrated good problem-solving skills.

· Able to track multiple tasks and complete promptly.

· Able to quickly build and maintain rapport with patients and providers of differing backgrounds; team player.

· Knowledge of Core Camarena computer applications (e.g., Healthport, Cerner, Dentrix, etc.)

· Knowledge of data processing methods and procedures; relating to Healthport.

· Knowledge of equipment and software characteristics of various computer systems and a general understanding of system features and their integration capabilities.

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