Billing Director

Feather River Tribal Health, Inc. • Oroville, CA

1d

About The Position

This department head position is responsible for the activities of the Billing Department as it relates to the patient billing system used by FRTH and its interaction with other operating systems. This person oversees the supervision of the coding, billing, and cash receipt posting and participates in the provider enrollment process with various 3rd party vendors. This position also works closely with other departments to identify the impact of measurable billing goals and objectives set by insurance companies and governmental agencies.

Requirements

• Ability to maintain a professional attitude and appearance at all times.
• Ability to meet deadlines and assigned projects in a timely, efficient manner.
• Demonstrate awareness, sensitivity and appreciation of Indian culture, traditions, customs and socioeconomic needs.
• Human relation skills to deal effectively with patients, clients, staff, Board members, community members and visitors in person and on the telephone.
• Must have the ability to communicate and write clearly and concisely.
• Ability to work under stressful conditions and time constraints.
• Ability to establish and maintain effective working relationships with the public and staff.
• Ability to work independently on a variety of responsible tasks.
• Knowledge of modern office equipment such as POS, copier, fax, computer, and Internet.
• Knowledge of computer software and its interaction with other systems.
• Ability to exercise balanced judgment in evaluating situations and making decisions.
• Ability to respond effectively to the most sensitive inquiries or complaints.
• Extensive knowledge of Medical, Dental, and BHS billing practices, including Medicare FQHC & IHS MOA billing regulations.
• Ability to read, interpret, and apply policies and procedures.
• Bachelor’s degree in related field – e.g. accounting or business administration, preferred; or
• At least five (5) years working experience in an ambulatory health care setting and business administration experience.
• AAPC Certified Professional Coder (CPC) & Certified Professional Biller (CPB) or equivalent certification required.
• At least three (3) years working experience as a supervisor.

Nice To Haves

• Candidates who do not yet meet the required education or experience qualifications may be considered for hire at an interim level. Compensation for such positions will be determined in consultation with the CEO and will remain in effect until all standard requirements are fulfilled.

Responsibilities

• Responsible for overall planning, organizing, workflow, administration, and management of the Billing Department and ancillary staff.
• Responsible for the development of operating policies and procedures of the department and their impact on other departments.
• Oversees the billing process for billable services provided by FRTH providers and staff.
• Ensures the monthly balancing and closeout of the billing system is completed timely in collaboration with the Fiscal Department.
• Responsible for setting measurable goals and objectives of ancillary staff and monitors progress of performance.
• Ensures Billing Supervisor and Coding Supervisor follow-up on submitted claims.
• Works with eligibility and patient enrollment staff to ensure patient compliance of resources.
• Works closely with staff to ensure the accuracy of insurance and coding information used by the agency for 3rd party billing and by staff for determination of resource for services.
• Works closely with Fiscal Department in the development of fee schedules for all departments.
• Evaluate and recommend changes to the billing system as it relates to payment sources, processes, and revenue generation.
• Serves as a member of the core team for implementation of software related to billing.
• Keeps up to date on changing rules and regulations as it relates to billing systems used by FRTH and its impact with outside regulatory agencies.
• Participates on the quality improvement committee and is responsible for activities of the Billing Dept including performance of audits and quality assurance activities.
• Prepares information for submission to the Fiscal Department as it relates to billing including coordination of electronic funds transmission.
• Participates in the payer credentialing process.
• Participates in forecasting of revenue generation in the development of annual budget including monitoring income from 3rd party sources.
• Oversees and/or produces a variety of reports used in the tracking and billing of services including aging report and third-party billings.
• On a monthly basis, monitors the bad debts as well as recommends timely refunds to appropriate entities.
• Works with all departments to help identify and provide training on a variety of issues related to billing activities.
• Implements policies and procedures for documenting, storing, and accurate retrieval of information maintained by the Billing Department.
• Works to maintain the cost effectiveness of the program.
• Maintains confidentiality in all matters.
• Responsible to ensure that accreditation standards of the organization are met as it relates to billing issues.
• Works closely with the IT Department on a variety of issues impacting billing operations of FRTH including front office data entry information used for billing claims.
• Works closely with clinical staff and EMR vendor to provide content updates, workflow analysis, enhancement of systems to optimize billing, training, and support of clinical users of the EMR.
• Audits, enters, and reviews data elements related to Indian Health Service requirements which may or may not be reimbursement related.
• Assists the Fiscal Department in the development of data and reports related to DHCS Reconciliation, HCAI (aka OSHPD) and Medicare Cost Report information.
• Responsible for the timely retention and destruction of records based on industry standards.
• Responsible to ensure that Billing staff is kept up-to-date and informed.
• Provides liaison activities and services to all departments, as appropriate.
• Attend all trainings, meetings and conferences as required.
• Works on special projects and reports as requested by the Chief Executive Officer.
• Performs a variety of duties as required to meet the needs of the department.
• May assist in preparing documents and responses for legal inquiries, litigation, and court appearances.

Benefits

• Health Insurance: Employer-paid medical coverage starting the month after hire for all tiers — Self, Self + One, and Self + Family
• Dental & Vision: 100% employer-paid for employee-only coverage; additional family coverage available at a competitive rate
• 401(k) Plan: Available immediately upon hire with a 4% employer match
• Life Insurance: $20,000 employer-paid policy for full-time employees, with options to purchase additional coverage
• Paid Time Off: Vacation begins accruing on your first day — up to 80 hours annually
• Loan Repayment Assistance Available

What This Job Offers

• Job Type: Full-time
• Career Level: Manager