Director of Medical Billing/Revenue Cycle

3 weeks ago

Columbus, United States Zoe Pediatrics Full time
Job Summary:
The Director of Billing is a key member of our organization, responsible for overseeing and optimizing all aspects of our billing operations. This role entails managing the Billing Department, ensuring compliance with Medicaid regulations, analyzing commercial contracts, and maintaining revenue cycle policies and procedures. Additionally, the Director of Billing is tasked with hiring, training, and retaining a skilled team of Revenue Cycle Specialists. This position reports to the Chief Operating Officer (COO) and collaborates closely with the Controller to reconcile cash collections and front desk functions.

Key Responsibilities:
* Assist in the development of the Key Management Report (KMR) to track billing performance metrics.
* Supervise the Billing Department, ensuring efficient and accurate billing processes.
* Stay updated on all Medicaid Bulletins for Georgia and Alabama Medicaid programs.
* Participate in analyzing yield on all commercial contracts to maximize revenue.
* Collaborate with the COO or designated personnel to reduce errors in the intake process.
* Maintain the charge master for both Zoe Pediatrics (Zoe Peds) and Zoe Applied Behavior Analysis (Zoe ABA).
* Develop and maintain company revenue cycle policies and procedures to ensure compliance and efficiency.
* Manage and maintain staffing levels within the Billing Department, including hiring, training, and retention of Revenue Cycle Specialists.
* Work with the COO and Controller to reconcile cash collections and front desk functions.
* Perform other necessary duties as required by the organization.

Education/Experience:
* College education required; Master's degree preferred but not required.
* Certification in Billing and Coding.
* Credentialing/Certification preferred but not required.
* Minimum of 5 years of experience in billing and collections.
* Proficiency in maintaining electronic databases.
* Valid driver's license and reliable transportation required.

Job Requirements:
* Strong oral and written communication skills.
* Attention to detail and organizational skills.
* Ability to maintain deadlines and operate in a fast-paced environment.
* Demonstrated positive attitude and interpersonal skills.
* Adherence to company dress code and time and attendance guidelines.
* Efficient time management and ability to multitask.
* Ability to accept feedback on work performance and collaborate effectively within a team.

Billing Responsibilities:
* Ensure timely billing of claims for Zoe Pediatrics and Zoe ABA for all payers.
* Generate and mail patient bills on a weekly basis.
* Maintain billing accuracy at 95% per biller.
* Keep all encounter inventories at 90 days or less from the date of service for all lines of business.
* Communicate with providers regarding claims inventories and outstanding claims actions.
* Transmit all claims through selected clearinghouse daily and resolve clearinghouse rejections promptly.

Payment Posting:
* Post payments daily and work on ERA payer denials promptly.
* Address un-reconciled balances daily to maintain financial accuracy.
* Meet with CEO, COO, and Controller monthly to review and write off doubtful accounts.

Revenue Cycle Reports:
* Generate biweekly reports on various aspects of the revenue cycle, including encounters, denials, and front desk errors.

\*Note: Key responsibilities are examples, and not all duties may be listed. Duties are subject to change based on business needs.

Job Type: Full-time

Benefits:
* 401(k)
* Dental insurance
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* 8 hour shift
* Day shift
* Monday to Friday

Experience:
* Medical billing: 5 years (Preferred)

Work Location: In person

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