Director of Billing - HealthCare

Full Time – Director of Billing

Under the guidance of the Assistant Vice President for Revenue Cycle Management, the role of the Director of Billing encompasses managing the billing and collections for California Medicaid. This individual will ensure the smooth operation of the process, maintaining efficiency and adherence to deadlines within the state. Responsibilities include managing claim production, processing rejections and invalid claims, generating invoices, handling denials, and reconciling submissions to secure revenue from payers and funding sources.

Responsibilities

• Responsible for proper generation of service charges into revenue for BayMark Health Services
• Reviews and monitors processes surrounding system processing and third party payers
• Reports any problems or adverse trends for metrics and goals to VP
• Responsible for ensuring billing tasks are done timely and effectively
• Act as an authority to escalated billing concerns and process workflow concerns from clinical and interdepartmental personnel to coordinate billing efforts and payer sequencing
• Create training materials for RCM staff and treatment center staff when appropriate (i.e. payer selection, modifiers, codes, timeframes, payers changes in plans)
• Must be able to train, counsel, monitor, and provide feedback to employees
• Assist in training new employees to ensure knowledge and skills essential for effective job performance are acquired.
• Provide continuous training and education to all staff to new departmental policies and changes in insurance requirements/regulations, etc.
• Perform regular assessments for each employee and provide constructive feedback to include action plans for improvement as needed.
• Oversee Payroll for assigned subordinates
• Review, coordinate, and create billing process workflows for existing and new business
• Lead conference calls with all sub-divisions across the US and discuss hot topics such as new payers and operational needs of treatment centers to ensure proper billing
• Participate in Acquisition and De Novo calls as well as participate in due diligence activities
• Prepare for and participate in monthly operational status and developmental calls.
• Prepare for and participate in bi-weekly management operational calls.
• Assist in hiring activities, evaluating employee performance and disciplinary actions/termination when necessary.
• Keep staff and patient information within the HITECH HIPAA privacy laws.
• Ability to handle stressful situations and interact with others.
• Must be present during working hours at the office for in person meetings and access to a computer without violating company policy.
• Comply with policies, procedures, compliance guidelines and Code of Conduct.
• Comply with internal controls, policies and procedures.
• Comply with BayMark policies and procedures, Compliance Policy and Code of Ethics.
• Conduct all business activities in a professional and ethical manner adhering to medical necessity compliance and financial compliance.
• Regular attendance is to be maintained.
• Interact with all levels of the organization in a positive and motivational fashion supporting the Company’s mission.
• Perform and complete special projects as assigned for all BayMark regions and billing modalities.
• Travel by plane or by car as required.
• May perform other duties as assigned

Minimum Qualifications

• Must be at least 18 years of age
• Previous physician office, hospital billing, or cash management experience required (5+years)
• Must have strong working knowledge in third party billing and reimbursement with an emphasis on Medicaid
• Candidates must have experience in medical terminology as it relates to our business, OTP coding and know thoroughly the authorization process
• Working knowledge of different MCO authorization requirements
• Excellent verbal and written communication skills
• Data entry experience. Ability to fill in for other employees as needed
• Compliance with all HIPAA policies
• Proficient in basic PC skills. Microsoft Word and Excel required
• Ability to multi-task and handle large volume of detail work accurately and efficiently and meet deadlines
• Compliance with accepted professional standards and practices
• Satisfactory references from employers and/or professional peers
• Satisfactory criminal background check
• Satisfactory drug screen

Benefits

• Competitive salary
• Comprehensive benefits package including medical, dental, vision and 401(K)
• Generous paid time off accrual
• Excellent growth and development opportunities
• Satisfying and rewarding work striving to overcome the opioid epidemic

Here is what you can expect from us:

BayMark Health Services specializes in the treatment of opioid addiction.  BayMark Health Services provides medication-assisted treatment services in a variety of modalities and settings through our divisions: BAART Community HealthCare, Health Care Resource Centers and MedMark Services, Inc.  BayMark Health Services, also provides traditional primary health care services, as well as integrated primary care, in select locations.

BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran’s status or any other classification protected by State/Federal laws.