Enrollment & Billing Director jobs in Lancaster, PA

Description

Our Mission, Vision, & Model of Care

At Union Community Care, our purpose is to spark equity through patient-led healthcare that welcomes and strengthens our communities by integrating body, mind, and heart.

We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member’s unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others.

We believe in whole health. This means we address and heal disease but equally important, we work at the causes of the causes, the social ills that must be addressed to achieve true equity.

We listen, learn, and embrace the complex lives and unique strengths of our patients, and we work hard to break down all barriers to care. This means we look through a grassroots lens. We connect with our communities because we are our communities. Each of us is a neighbor, a friend, a family member, and together, we are a trusted community health center.

Qualifications

JOB SUMMARY

Reports directly to the Chief Financial Officer and is responsible for the overall performance of Union’s revenue cycle. This position does the following: develop, plan, organize and implement current and future strategies to bill patients, process payments, minimize timely filing adjustments, improve cash flow and manage the organization’s patient receivables. Also responsible for managing the activities of the revenue cycle functions of billing, collections, and accounts receivable for patients. In addition, this position will work hand-in-hand with Union’s Director Team to ensure that best practices are developed, implemented and problem-solved at the right level and a manner that supports the Empowerment Model.

SPECIFIC JOB DUTIES

1. Develop workflows for the billing department and ensures that objectives are properly defined and clearly established
2. Develop policies and procedures and implements to ensure consistent company-wide adherence
3. Ensures that operating expenses are well within the prescribed limits of budget plans and fiscal guidelines
4. Monitors timeliness and effectiveness of department activities, ensuring outstanding patient accounts are within reasonableness time
5. Monitors collection efforts and maintains insurance billings are current and within the established time frame specified in department policy
6. In collaboration with the Human Resources Department conducts in-depth interviews and hires, trains, supervises, and monitors the performance of all Billing staff
7. Functions as a working Director by assisting whenever necessary in the billing/collection process and maximizing the utilization of staff resources
8. Complies with all Union policies, including those related to patient privacy.
9. Establish and maintain procedures for efficient and accurate processing of medical, dental, and behavioral health encounters and collection of claims. This includes, but is not limited to, the following:
   1. Ensure collection and accurate entry of patient demographic and billing information
   2. Communicate with patients with regards to insurance eligibility, outstanding balances, and other related matters
   3. Review all encounters and pertinent information weekly; coordinate the paper/document flow related to billing and patient accounts
   4. Ensure bills are submitted to insurance carriers on clean claims and in a timely manner
   5. Ensure cash is posted daily to patient accounts and reconciled, and charges are dropped daily
   6. Review the patient accounts receivable monthly to determine where concerted collection efforts are needed
   7. Offer a reasonable payment plan to patients when required to avoid dismissal due to non-payment
   8. Identify, establish, and maintain relationships with third party insurers
   9. Understand policies and procedures of each accepted insurance plan and communicate the information to appropriate staff
   10. Negotiate favorable terms with major insurance carriers to maximize revenue and reduce contractual allowances
   11. Maintain a Contract Book for all insurance plans
   12. Maintain Fee Schedules, to include third parties, for proper contractual allowance recognition at time of service/billing
   13. Be a liaison between the medical electronic record vendor and the billing department. Manage reported issues to ensure timeliness of response and closure
   14. Communicate and effectively resolve related billing issues, new regulations, or other matters with appropriate parties
   15. Review Billing Operations with Chief Financial Officer on a biweekly basis
   16. Ensure 100% adherence to the sliding fee discount scale program
   17. Oversight of credentialing of providers and any updates required. Work closely with Human Resources and billing personnel to ensure proper and timely credentialing is completed.
   18. Provide weekly/monthly/quarterly Key Performance Indicator reports to CFO and other designated personnel.
10. Performs other work duties as assigned

POSITION REQUIREMENTS

Associates or Bachelor’s degree preferred

7-10 years of experience preferred

Certified Professional Coder preferred

Supervisory experience required

Demonstrated knowledge of both medical/dental office practices and billing experience required

Ability to utilize Patient Accounting Software

Proficiency required in a computer spreadsheet or word processing package, i.e. Excel, or Word

English proficiency required

Familiarity with medical and dental terminology

Good interpersonal skills

ESSENTIAL FUNCTIONS

In order to fulfill the requirements of this position, duties 1-9 are considered essential functions of the job.

ORGANIZATIONAL INVOLVEMENT

This position is required to participate in mandatory all staff meetings, team meetings and trainings.