Director of A/R and Billing

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. This will be a hybrid work environment (partially remote, 3 days in office, 2 days remote).

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

Qualifications:

  • 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.

To apply for this job email your details to hr@telmedical.com