Project Health Inc.
We are currently seeking a full-time Director of Accounts Receivable and Billing in Sumterville, Florida. We are a non-profit Federally Qualified Health Center located in Central Florida. Great Benefits offered to include health insurance(medical, dental, vision), FREE medical co-pays, paid time off, eight paid holidays, 401K matching, company paid life insurance and short term disability, long term disability, flexible spending accounts, loan forgiveness and much more.
Primary responsibilities include but are not limited to:
- Serves as liaison between the organization and the billing agent to ensure timely billing practices are enforced and collection activity remains positive.
- Monitors billing practices, contracts and compliance
- Collaborates with key team members to secure additional payer sources, offers expertise on contract term(s) and fee schedule negotiations.
- Provides direction and oversight to help improve operations, decrease turnaround times, streamline work processes, and work cooperatively to provide quality seamless customer billing experiences.
- Manage & develop the internal patient accounting functions to include; review of A/R reports, sliding scale, refunds, collections, patient invoicing and special reporting/projects
- Ensures compliance with state collection and credit regulations; interprets and complies with applicable state/federal regulations, laws, and guidelines.
- Manages overall goals and activities of the team, identifying problem areas and developing a pro-active action plan to resolve issues.
- Collaborate with key team members to assist with the successful implementation of new service line projects.
- Assigns and prioritizes staff members’ duties and monitors quality of work; assures staff conforms to organizational policies and procedures and government regulations.
- Provides day-to-day guidance and oversight of billing team members, some of which are working remotely; actively works to promote and recognize performance and foster professional development.
- Oversees and ensures accuracy of coding; codes services provided utilizing CPT and ICD-10 coding.
- Researches and processes refund requests and overpayments.
- Prepares specialized reports for tracking and trending A/R statistics.
- Ensures A/R exceeding 90 days is thoroughly and actively worked to ensure that claims are resolved in a timely manner.
- Ensure A/R that exceeds 151 days is worked weekly to reduce aging to an appropriate timeframe. Accounts in a 151-day status should be minimal.
- Communicates with payees to answer questions and provide additional supporting documentation.
- Prepares letters of appeal to insurance companies if the company refuses to pay contracted claims and/or denies a claim; submits documentation necessary to support claim; resubmits claims with corrections if needed for payment for all insurance payers.
- Collaborate with team members to complete timely assigned portion(s) of the Uniform Data System (UDS) report annually.
- Perform/Oversee “month end close” functions of accounts receivable system monthly.
- Enters data and charges from charts into the billing system; generates all required reports.
- Generates and submits electronic claims and statements at designated intervals; analyzes and corrects any errors for complete and accurate transmission of data.
- Performs other duties as assigned by the Executive Management Team
- Relevant Associate’s and/or Bachelor’s degree and experience REQUIRED
- Five years of work in the field and appropriate certifications related to ICD-10
- Three years supervisory experience is necessary
- Excellent writing and analytical skills are REQUIRED
- Ability to adapt to a changing environment and handle multiple priorities
To apply please email your resume to the reply link or fax to 855-832-3504, attention Human Resources. We are an equal opportunity employer and drug-free workplace. COVID Vaccine Mandate Option Required.
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