Director Of Physician Billing – Remote

This job is responsible for all aspects of billing, including claims management, insurance collection, payment posting, and complete account resolution.

This position ensures that all billing activities meet the standard of regulatory requirements with the highest degree of integrity.

ESSENTIAL RESPONSIBILITIES:

• Directs and administers the operations, programs, and activities of the physician billing office, ensuring that processes and data meet regulatory requirements and AHN policies.

• Monitors and produces best practice standards in a billing environment including days in A/R, cash/net revenue, A/R aging, denials management, credit balances, and other relevant performance indicators.

• Develops and implements policies and procedures related to the Patient Financial Services department that support the management philosophy and division financial goals and objectives.

• Directs and oversees plan to transition from legacy billing system to EPIC billing system.

Plan includes staff hiring, training, implementation, and monitoring of metrics to ensure success.

• Supervises management team and staff, providing direction and guidance that fosters a team environment through training, recognition/evaluation, and in-service education which produces optimum work habits.

Mentors and coaches to achieve highest level of competency of leadership and staff.

• Manages staff relations including performance management, staff satisfaction and conflict management.

• Prepares, monitors, and maintains annual expense budget.

• For Physician Organization Only: Manages, supervises and reviews auditing and educational work of the physician compliance auditors.

• For Physician Organization Only: Performs compliance investigations originating from internal or external sources, compiling support documentation for results and proposed action plans to address potential areas of improvement and/or noncompliance.

Conducts investigations and performs special projects as assigned.

QUALIFICATIONS :

Minimum

• Bachelors Degree

• 8 years in financial or revenue cycle/credit and collection

• 5 years in a leadership role

Preferred

• Masters Degree in a related field (business, finance, healthcare administration)

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title.

It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct.

This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.

Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.

Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.