Job Details

Job Type

Full-time

Description

Develops and implements improvements to the facility's billing and collections activities and ensures revenue cycle compliance. This position is responsible for communication with clinicians and RCM team on a regular basis. This position may also require light travel on occasion.

ESSENTIAL FUNCTIONS:

• Provides direction to the RCM team regarding billing operations, billing and collection, coding and compliance, reimbursement and third-party contract compliance, and reporting.
• Coordinates with employees responsible for charge capture or entry, coding, reimbursement, or insurance verification to identify and resolve issues impacting billing or collections.
• Identifies causes of non-compliance or account/payment delinquency. Analyzes trends in under/overpayment, payment denial, or appeals and develops process improvements meant to improve operations and reduce costs.
• Ensures compliance with all relevant reporting and data collection regulations.
• Provides training and education relative to regulatory and billing requirements.
• Tracks metrics to develop and implement strategies for improvement.
• Manages the policies, objectives, and initiatives of RCM activities to meet target operational and revenue goals.

QUALIFICATIONS: [Education, Training, Knowledge, Skills, Abilities, and Expected Behaviors]

Required:

• -A High School Diploma or equivalent.
• -Podiatry experience preferred.
• -Certified Professional Coder (CPC) a plus but not required.
• -Minimum of 5 years' experience interpreting insurance explanation of benefits.
• -Minimum of 3 years' experience with medical claims, billing, payment posting and insurance collections.
• -Knowledge of all insurance guidelines especially Medicare and Medicaid according to standards.
• -Knowledge of legal, regulatory, and policy compliance issues related to medical coding and
• billing procedures and documentation.
• -Experience with prior authorizations, pre-determinations, and out-of-network gap exceptions.
• -Ability to supervise and mentor others.
• -Ability to use independent judgment and to manage and impart confidential information.
• -Must communicate logically and clearly both orally and in writing.
• -Must be able to travel occasionally to practice sites and trainings as needed.
• -Legal eligibility to work in the United States without sponsorship now or in the future.

-Ability to successfully pass a background investigation / pre-employment screening, including a valid Driver's License and clean DMV record with proof of insurance is required or any combination of academic education and professional training and development along with applied work experience that demonstrates the ability to successfully perform the essential functions of the position. Employees must reside in one the of following states: AZ, AL, CA, CO, DC, FL, HI, ID, IL, IN, MA, MI, MO, NC, NM, NV, OH, SC, TN, TX, UT, WV, VA.

Benefits of working with Balance Health:

• Medical
• Dental
• 401k with 4% matc
• Company paid short-term disability
• Long term disability
• Company paid life insurance
• Pet insurance
• PTO Plan