The primary function of this position is to implement and maintain the national operations of U.S.VETS’ medical billing activities by coordinating and collaborating on all areas regarding reimbursement to U.S.VETS for insurance-eligible services. This position reports directly to U.S.VETS’ Vice President of Clinical Services.
FLSA Classification: Exempt
Responsibilities:
- Coordinates the implementation and operation of medical billing to health insurance providers for reimbursement of services provided to veterans and their families across U.S.VETS sites nationwide.
- Perform as the practice expert and point of contact for all processes related to medical billing.
- Obtains and utilizes market analysis to determine U.S.VETS’ services eligible for insurance billing and applicable insurance carriers and advises on opportunities to add or increase billable services.
- Collaborates with U.S.VETS’ staff and consultants to develop, execute, and ensure adherence to medical billing policies, procedures, workflow, and systems, providing experience-driven guidance.
- Supports U.S.VETS sites in applying to be eligible providers to bill Medicaid, Medicare, and other insurance providers; negotiates contracts with payers.
- Ensures compliance with applicable State, Federal, and payer requirements and regulations.
- Develops and oversees procedures for staff to assist clients in applying for and accessing health insurance and determining eligibility and insurance verification at intake to ensure a streamlined, efficient process for timely access to health services.
- Coordinates and/or provides quality and appropriate training to new hired and existing staff on medical billing processes and systems.
- Monitors utilization, accuracy, and efficiency of medical billing-related procedures and implements strategies and corrective actions as needed.
- Ensures all locations obtain and maintain National Provider Identifier (NPI) numbers and required licensure/certifications for providing billable services.
- Coordinates the implementation and/or updating of electronic client records and medical billing software systems and related staff training.
- Collaborates with the internal Accounting Department and contracted billers to ensure timely and accurate billing submission and reimbursement.
- Attends departmental meetings to advise on ways to increase productivity, troubleshoot billing errors and rejected claims, and implement quality improvement strategies as needed.
- Develops strong business relationships and interfaces with insurance carriers when needed.
- Assesses staffing needs for medical billing department, creates job descriptions, and supervises and/or provides direction to applicable staff.
- Compiles and analyzes data from all sites and sources; prepares reports for management, government, and other agencies; and projects income associated with various medical billing revenue streams.
- Collaborates with Development and Operations department to seek out additional revenue sources through government or other contracts to provide health services.
- Implements and manages awarded contracts related to health services.
- Manages U.S.VETS’ medical billing activities by providing guidance, support, training, and supervision to each site and applicable staff.
- Ensures compliance required client eligibility, insurance, case file, and other documentation.
- Prepares medical billing-related proposals, budgets, modification requests, reports, and application packages in collaboration with Operations, Finance, & Development Departments.
- Develops and maintains a national database to track insurance carrier applications/approvals, contracts, and eligible services of all sites.
- Monitors trends of the health insurance market and guides leadership and service staff accordingly.
- Participates in trainings for professional development and remaining knowledgeable of trends and best practices to advise U.S.VETS leadership and ensure optimal performance.
- Remain updated on HIPAA and all other health information management issues and regulations and implement policies and procedures accordingly.
- Makes decisions on behalf of U.S.VETS related to medical billing with authorization of supervisor and other national executive staff as required.
- Maintains and submits time sheets, mileage logs, and other required documentation accurately and in a timely fashion.
- Travel as needed to support national efforts.
- Handles special projects and performs other duties as required or assigned.
Requirements:
- Bachelor’s degree in Healthcare Administration, Business Administration, or related field required; Master’s degree in related field preferred. Specialized education in the medical field preferred.
- Certification in Medical Insurance Billing & Coding preferred.
- Minimum of 5 years of related work experience required to include in-depth knowledge in medical insurance/healthcare billing and coding.
- Minimum of 3 years of supervisory and management experience in related field required.
- Experience working with social service and/or non-profit organizations preferred; especially those providing outpatient and/or residential services to the homeless and/or veteran population.
- Medicaid, Medicare, and third-party payer billing experience required.
- Possess profound knowledge and understanding of rules and regulations affecting medical billing and insurance verification.
- Current knowledge of technologies in the health information sector and their applications to include electronic medical records and billing systems as well as Microsoft Office applications is required.
- A successful track record in setting priorities and effectively organizing, scheduling, and handling multiple tasks to ensure practice timelines are met.
- Keen analytic, organization and problem-solving skills which support and enable sound decision making.
- Strong ability to train and supervise the work of employees.
- Excellent communication and relationship skills with an ability to prioritize and work with a variety of internal and external sources in person, virtually, by telephone, and in writing.
- Demonstration of personal qualities of integrity, credibility, and dedication to the mission of the organization.
- Leadership and conflict management skills.
- Strong ability to display exceptional initiative and work independently with minimal oversight as well as the ability to take direction and work within a team.
U.S.VETS is a non-profit organization whose mission is the successful reintegration of homeless veterans to their highest level of independence. We provide service-enriched housing to homeless veterans throughout the country including the states of California, Hawaii, Texas, Nevada, Arizona, and in the district of Washington, D.C.
To apply visit: https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=33054&clientkey=AC964D99781EE6B7BAD7D79276AA0397
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Job Requirements:
- Maintain client billing profiles in billing system
- Provide records of billing, payments and billing adjustments
- Preparing all billing reports and maintain all billing and accounts receivable files
- Enter patient demographics and billing information into billing system
- Assisting billing coordinators with various billing-related projects
- Resolve customer account billing issues
- Reconcile any billing or payment discrepancies
- Send out monthly billing statements
- Manage system auto-billing, intercompany billing, and miscellaneous manual billing
- Create billing schedules and various other billing analyzes
- Performing dental insurance billing and posting payments
- Ensure timely billing and collections
- Maintain the client-billing accounts receivables
- Interpret reports regarding billing and payments
- Understanding billing procedures and payment
- Address and resolve billing discrepancies
- Answering customer billing questions and troubleshooting billing issues and inquiries
- Ensure timely billing and collection
- Maintain all billing information submitted and entered into billing database
- Streamline billing and collections processes