The Director of Billing is a member of Thresholds’ Finance Team reporting to the Chief Financial Officer. The Director is responsible for designing, implementing, and enforcing policies and procedures, as well as stream lining effective billing and collections (revenue cycle) processes across the Agency. The Director has overall responsibility for the billing and collections functions within Thresholds and will assess and improve all major stages in the revenue cycle, which are summarized as follows:
2. Point of service registration, financial counseling, and past due collections
3. Encounter utilization review and case management
4. Charge capture and coding
5. Claim submissions
6. Third party follow-up
7. Remittance processing and rejections 8. Payment posting, appeals, and collections
ESSENTIAL DUTIES & RESPONSIBILITIES
- Direct all billing and revenue collections / recovery activities.
- Oversees and directs activities of accounts receivable department engaged in generating bills for client services, reviewing and posting payments and cash, and auditing and correcting bills and accounts.
- Oversees hiring, orientation, training, evaluation and ongoing supervision of the billing and collections team.
- Coordinates with Information Technology staff on changes in business processes to utilize new technology and ensure efficiency.
- Regularly meets and consults with department heads and site managers in order to identify department needs and requirements; and resolve operational problems and barriers to providing effective service.
- Checks and verifies data as necessary to ensure correct funding sources, service codes, rates and postings; and initiates corrective actions to reconcile discrepancies.
- Develops and implements policies and procedures for cash receipts, client billing, insurance claims processing, and unpaid invoices in compliance with funding agency contracts and terms, and overall objectives.
- Advises site managers of policy and procedures, and elicits cooperation to facilitate the process.
- Contributes to the completion of financial forecasts such as cost center salary and direct expenses, month-end financial reporting, including daily/weekly and monthly “Dashboard” report detailing A/R balance, Net Days Outstanding, Aging, Uncompensated Care, Contractual Allowances, Cash Collections, Denial rates and any other metrics or reporting cadence required by the Agency or payers.
- Directs the efforts of the Institution’s Denial Management/Change Management work groups in designing new processes that will prevent future denials.
- Participate in the Corporate CHE Revenue Management activities and initiatives. Plans, coordinates and prepares for year-end audits with public accounting firms and third party auditors as they relate to A/R operations. Assist in resolving issues regarding findings.
- Assess organizational and customers’ needs and develops innovative “best practice” programs to ensure customer satisfaction.
- Overseas the financial interface between Revenue Cycle functions and functions of the Controller’s Office (especially, General Ledger).
- Provides leadership insight for Patient Access, Coding, Revenue Recovery, and Patient Financial Services.
- Incorporates the Institution’s core values into staff development practices and all cross-departmental activities.
- Communicates regularly, consistently and effectively with staff regarding the status of new system-wide and Revenue Cycle initiatives and keeps staff updated and trained on compliance issues.
- Responsible for managing the adherence to 3rd party vendor and managed care plan contracts. Directly manages all contracts with external vendors, including outsourcing of vendors and collection agencies.
- Supports the Institutions CFO in a leadership capacity in developing mutually effective 3rd party managed care plan contracts.
- Assists in maintaining 3rd party payer contracts and in negotiating renewals and or new contract terms. Ensures that 3rd party contracts are understood by staff to ensure that the Institution is paid correctly according to contract terms.
- Other duties as assigned. MARGINAL DUTIES & RESPONSIBILITIES May be required to represent the Agency and department in leadership roles with external community organizations, trainings, conferences, or advisory boards.
- May be required to work a flexible schedule as required by CFO.