Billing Director

POSITION SUMMARY:

This department head position is responsible for the activities of the Billing Department as it relates to the patient billing system used by FRTH and its interaction with other operating systems. This person

oversees the supervision of the coding, billing, and cash receipt posting and participates in the provider enrollment process with various 3rd party vendors. This position also works closely with other departments to identify the impact of measurable billing goals and objectives set by insurance companies and governmental agencies.

ESSENTIAL FUNCTIONS:

1. Responsible for overall planning, organizing, workflow, administration, and management of the Billing Department and ancillary staff.

2. Responsible for the development of operating policies and procedures of the department and their impact on other departments.

3. Oversees the billing process for billable services provided by FRTH providers and staff.

4. Ensures the monthly balancing and closeout of the billing system is completed timely and submitted to the Fiscal Department.

5. Responsible for setting measurable goals and objectives of ancillary staff and monitors progress of performance.

6. Ensures Billing Supervisor and Coding Supervisor follow-up on submitted claims.

7. Works with eligibility and patient enrollment staff to ensure patient compliance of resources.

8. Works closely with staff to ensure the accuracy of insurance and coding information used by the agency for 3rd party billing and by staff for determination of resource for services.

9. Works closely with Fiscal Department in the development of fee schedules for all departments.

10. Evaluate and recommend changes to the billing system as it relates to payment sources, processes, and revenue generation.

11. Serves as a member of the core team for implementation of software related to billing.

12. Keeps up to date on changing rules and regulations as it relates to billing systems used by FRTH and its impact with outside regulatory agencies.

13. Participates on the quality improvement committee and is responsible for activities of the Billing Dept including performance of audits and quality assurance activities.

14. Prepares information for submission to the Fiscal Department as it relates to billing.

15. Coordinates with the Fiscal Department, the electronic funds transmission process.

16. Participates in forecasting of revenue generation in the development of annual budget including monitoring income from 3rd party sources.

17. Oversees and/or produces a variety of reports used in the tracking and billing of services including aging report and third-party billings.

18. On a monthly basis, monitors the bad debts recommended for submission to outside collection agencies as well as recommends timely refunds to appropriate entities.

19. Works with all departments to help identify and provide training on a variety of issues related to billing activities.

20. Implements policies and procedures for documenting, storing, and accurate retrieval of information maintained by the Billing Department.

21. Works to maintain the cost effectiveness of the program.

22. Maintains confidentiality in all matters.

23. Responsible to ensure that accreditation standards of the organization are met as it relates to billing issues.

24. Works closely with the IT Department on a variety of issues impacting billing operations of FRTH including front office data entry information used for billing claims.

25. Works closely with clinical staff and EMR vendor to provide content updates, workflow analysis, enhancement of systems to optimize billing, training, and support of clinical users of the EMR.

26. Audits, enters, and reviews data elements related to Indian Health Service requirements which may or may not be reimbursement related.

27. Assists the Fiscal Department in the development of data and reports related to Code 02, Code 18, HCAI (aka OSHPD) and Medicare Cost Report information

28. Responsible for the timely retention and destruction of records based on industry standards.

ADDITIONAL RESPONSIBILITIES:

1. Responsible to ensure that Billing staff is kept up-to-date and informed.

2. Provides liaison activities and services to all departments, as appropriate.

3. Attend all trainings, meetings and conferences as required.

4. Works on special projects and reports as requested by the Chief Executive Officer.

5. Performs a variety of duties as required to meet the needs of the department.

6. May assist in preparing documents and responses for legal inquiries, litigation, and court appearances.

KNOWLEDGE, SKILLS AND ABILITIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

1. Ability to maintain a professional attitude and appearance at all times.

2. Ability to meet deadlines and assigned projects in a timely, efficient manner.

3. Demonstrate awareness, sensitivity and appreciation of Indian culture, traditions, customs and socioeconomic needs.

4. Human relation skills to deal effectively with patients, clients, staff, Board members, community members and visitors in person and on the telephone.

5. Must have the ability to communicate and write clearly and concisely.

6. Ability to work under stressful conditions and time constraints.

7. Ability to establish and maintain effective working relationships with the public and staff.

8. Ability to work independently on a variety of responsible tasks.

9. Knowledge of modern office equipment such as POS, copier, fax, computer, and Internet.

10. Knowledge of computers software and its interaction with other systems.

11. Ability to exercise balanced judgment in evaluating situations and making decisions.

12. Ability to respond effectively to the most sensitive inquiries or complaints.

13. Knowledge of Medical, Dental, and BHS billing practices including use of a variety of systems.

14. Ability to be punctual with minimal absences.

15. Ability to read, interpret, and apply policies and procedures.

EDUCATION AND EXPERIENCE:

1. Bachelor’s degree in related field – e.g. accounting or business administration, preferred; or

2. At least five (5) years working experience in an ambulatory health care setting and business administration experience.

3. At least three (3) years working experience as a supervisor.

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.

While performing the duties of this job, the employee is required to use hands to finger, handle or feel; reach with hands and arms; stoop, kneel or crouch; talk and hear within normal range. The employee is frequently required to stand, walk, sit, climb or balance and use taste and smell senses. The employee may occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. This position can be emotionally challenging. Ability to deal with time constraints and emotional stress are also essential functions of the job.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly exposed to odors and airborne particles. The noise level in the work environment is usually moderate.

Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act (Title 25 U. S. Code, Section 472 and 473). Applicants claiming Indian Preference must submit verification of Indian descent certified by tribe of affiliation or other acceptable documentation of Indian heritage. In other than the above, Feather River Tribal Health is an Equal Opportunity Employer.

Feather River Tribal Health, Inc. is a drug and alcohol-free workplace. As a federally funded Tribal Health Program, FRTH must comply with Executive Order No. 12564 (Sept. 15, 1986)(51 F.R. 32889 (requiring a Drug Free Workplace) and the Drug Free Workplace Act of 1988 (U.S.C. 8101-8106). As such, FRTH does require drug testing at the time of hire and upon reasonable suspicion after hire. All FRTH employees are required to comply with FRTH’s drug free workplace policies and applicable federal laws as a condition of employment.

Reasonable accommodations will be given to qualified disabled applicants pursuant to Section 501 of the Rehabilitation Act of 1973, 29 U. S. Code 791, Title 29, and the Americans with Disabilities Act (ADA).

Job Type: Full-time

Pay: From $37.42 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Management: 3 years (Preferred)
• Microsoft Excel: 1 year (Preferred)
• Professional Certified Coding: 1 year (Required)

Work Location: In person