Careers

Position Summary:  Management position responsible for directing and coordinating the overall functions of the LHPG medical billing and patient financial services department.  Will ensure the maximization of cash flow while improving patient, insurance company and physician relations.  Requires strong managerial, leadership and business office skills and the ability to produce and present detailed billing activity reports.

 Key Responsibilities Include, But Are Not Limited To:

• Oversees the operations of the billing department, including validation of CPT/ICD-10 Code assignment, charge entry, claims submission, payment posting, accounts receivable follow-up, and reimbursement management
• Serves as the practice expert and go to person for all documentation and billing processes including RHC billing requirements, appropriate use of modifiers, specialty provider coding, etc.
• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
• Analyzes claims for accuracy and completeness; submits claims to proper insurance entities and troubleshoots issues.
• Analyzes insurance reimbursement for proper payment of claims according to contracts.
• Communicates with Clinic Coordinators/Receptionist regarding registration information issues and provides education as appropriate.
• Prepares and analyzes accounts receivable reports, financial reports, insurance contracts, and compiles accurate statistical reports as requested by clinic Administration. 
• Drafts department policy and procedures, participates in their implementation and audits current procedures to monitor and improve efficiency of billing and collections operations.
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
• Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.  Implements performance improvement plans in order to meet key metrics as set by Clinic Administration. 
• Analyzes trends impacting charges, coding, collection, and accounts receivable and takes appropriate action to realign staff and revise policies and procedures.
• Keeps up to date with carrier rule changes and distributes the information within the practice.
• Performs physician credentialing actions
• Understands and remains updated with current coding and billing regulations and compliance requirements.
• Maintains a working knowledge of all health information management issues such as HIPAA.
• Participates in continuous learning and stays abreast of changes in reimbursement and communicates these changes to Clinic Administration.  Responsible for design and implementation of  modifications in current practices to meet these changes.
• Supervises billing office personnel, which includes work allocation, training and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.  Coordinates team member time off so that is does not negatively impact necessary daily functions.
• Performs other miscellaneous job-related duties as assigned.

Education / Certification / Experience Requirements:

• Education:  Associate's degree required, preferably in Business or Accounting or related field; Bachelor's Degree preferred
• Certificate coder is a plus
• Prior experience working in an electronic medical records and practice management system is a must
• Minimum of 5 years of experience in medical insurance/healthcare billing and collections in a medical practice or health system with a deep understanding of medical billing rules and regulations
• A combination of education and experience will be considered