The Director of Medicaid Billing and Revenue is responsible for ensuring timely and accurate processing and transmitting of Medicaid billing, managing consumer records and accounts, monitoring utilization of services. Coordinates data entry of record service hours with data entry staff, develops appropriate and complete bills, transmits bills through systems carrier and reconciles funds collected with all billed claims ensuring accuracy, completeness and accountability. In addition, the Director is responsible for informing and training appropriate staff on any new billing procedures work closely with the Vice President and Administrative office to ensure that the programs are meeting the requirements of Medicaid and local funding sources' billing standards, and the programs accurately maintain required financial files of the individuals served.
PHYSICAL REQUIREMENTS :
- Supervises a team of medical billers to ensure all billing and collection process are current and up to date.
- Oversees and ensures the electronic billing system is set up and operating properly.
- Works with the program staff to ensure current Individual's information and status is entered in the system accurately and maintained for collection and services offered.
- Ensures records of service hours are accurately entered in the system for each individual in each program. Ensures all billable hours/claims are accounted for, reporting omissions or discrepancies.
- Extracts, posts, reviews, and transmits complete Medicaid billing for all programs.
- Reconciles and confirms all billing reports received with the services performed and claims transmitted. Report problems or discrepancies.
- Identifies and analyzes problems and implements solutions as needed or instructed.
- Ensures re-billings are completed as appropriate and that all Medicaid billings
- (DDSIDOH) are complete and finalized within a scheduled time of ram
- Electronic Forwards of checks with correct coding information to accounts receivable.
- Manages and keeps records of all individual funds as required.
- Maintains open communications with all related staff to facilitate and resolve billing issues and problems any denied claims. Initiate meetings with staff as needed.
- Develops and maintains open communications and positive relationships with community resources and agencies as needed to effect and enhance the billing process.
- Maintains current knowledge of the billing process and state and local billing procedures.
- Maintains working knowledge of the VOAC Policies and Procedures and program procedures as related to operations, services and billing.
- Responsible for keeping required records of service related items in conjunction with finance.
- Attends staff and organizational meetings as required.
- Performs other duties as assigned.
The physical requirements described below are representative of those that must be met by an employee to successfully perform the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
OTHER DUTIES :
- The ability to safely operate a motor vehicle to transport oneself, consumers, and program supplies as necessary.
- The physical ability to travel to assigned locations, stand, stoop, bend, reach, pull, push, lift, grasp, climb, talk, see, hear and perform basic and light home maintenance activities, and operate office equipment.
- Operating office equipment requiring continuous or repetitive hand/arm movements.
- The ability to remain in a sitting position for extended periods of time
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. REQUIREMENTS
- Bachelor's Degree in Healthcare Administration or related field. Masters preferred.
- Minimum (5) five years of experience working with Medicaid payments or medical revenue cycle billing.
- Specialized training in Medicaid or healthcare billing procedures and revenue cycle
- Experience with reconciliation of billing coding errors for reimbursement
- Collection experience with providers to address errors
- Able to identify report and analyze problems or discrepancies in medical billing processes and develop solution for problem resolutions.
- Keen attention to detail, multitask, meet deadlines, flexibility to work with different aspects of the organization and other program leaders and support units.
- Ability to research, prepare, maintain and review reports and documentation with timeliness and accuracy.
- Strong problem solving and execution skills.
- Culturally responsiveness with an ability to work with individuals from diverse backgrounds.
- Excellent written and verbal communication skills;
This job has expired.
- Experience with Microsoft Office (Word, Power-point, Excel, Outlook)
- Ability to understand various technology systems and general office resources.
- Excellent organizational and execution skills.
- Bilingual in any language a plus.