Billing Director *** Urgently Hiring

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Description

Full Time: Monday to Friday: 8:30 am to 5:00 pm

Salary: $90,000 to $95,000 / Exempt

Hybrid - Remote & Office

Benefits and Perks: Supportive, fun and friendly team environment!

• Clients/Families we serve reside in the South Los Angeles, Compton, Watts and Lynwood area.

SHIELDS' mission is to develop, deliver and evaluate culturally sensitive, comprehensive service models that empower and advocate for high-risk families in South Los Angeles.

Summary:

• Work with the Executive Team to plan, organize, direct and lead the work processes of the billing department.

• Work with Funders in collaborative workgroups and meetings to identify, resolve, plan and project for all agency billing functions and operations.

• Develop and facilitate/co-facilitate trainings with managers, leads and supervisors regarding billing-related procedures.

• Develop billing systems policies which maximize efficiency and accuracy and are compliant with all local, County, State and Federal guidelines.

• Work with the QA/QI Director to process, maintain, compile, and report patient information for health requirements and standards in a manner consistent with the healthcare industry.

• Develop best practice procedures to mitigate claim denial and eligibility issues. Train staff to utilize these procedures and monitor timeliness of completion.

• Compile, review and provide a wide array of billing reporting for Executive staff. Interpret billing data and provide recommendations to Executive team.

• Monitor and report on funding utilization and work effectively with Program supervisors to maximize utilization across funding streams.

• Meet with Program leads/supervisors on a regular basis to review billing utilization and provide recommendations for program operations to maximize current utilization.

• Modify EHR system setup as necessary.

• Responsible for all functions of the billing department.

Primary Duties:

• Provide administrative support for the Executive Team.

• Monitor and report on all claim submissions and statuses.

• Develop procedures for claim remediation and resubmission per agency deadlines.

• Monitor program-level performance and report out to the Executive Team and Management staff on a regular basis.

• Develop tracking and monitoring tools to assist in reporting and increased communication.

• Develop a billing manual to include all policies and procedures related to billing functions. This manual should be used for onboarding of new billing staff, and for reference. This manual must be updated regularly.

• Review, log and track employee training needs as it relates to billing and claim submission. Work closely with QA/QI to implement necessary trainings.

• Cross-train billing staff/leads on all fee-for-service billing operations.

• Cultivate lead billing staff skills to include reporting, monitoring and tracking of billing staff performance, training development and facilitation and related tasks.

• Review documentation submission to the billing department and implement modifications as needed to increase efficiency and accuracy.

• Compile/Review all fee-for-service funder documentation, inclusive of SDP, utilization reports, and other documents as requested.

• Plan and project the budget for the billing department on an annual basis.

• Meet regularly with Program Supervisors for program performance reviews and related updates.

• Communicate effectively with agency staff regarding changes in billing protocol and claiming regulations which impact providers.

• Monitor error resolution and deadlines.

• Monitor, Track and resolve remediation of past claim denials pending submission to current EHR.

• Coordinate with QA for program-level support and information needed for audit purposes.

Requirements

These specifications are general guidelines based upon the minimum, ordinarily considered essential, to satisfactory performance in this position. The individual in this position is required to have obtained a BA in a related field, MA preferred. The individual in this position is required to have at least 5 years of related billing and management experience. Individual skills and abilities may result in some deviation from these guidelines.

To perform effectively in this position, the employee in this position is required to have:

• Extensive knowledge of medical billing and coding.

• Knowledge of the Department of Mental Health documentation.

• Functional knowledge of EHR systems preferred.

• Extensive knowledge of the EDI claiming process and claim remediation procedures and protocols.

• Provides services within a culturally sensitive, ethnic informed model of practice and is respectful to the community and clients

• COVID-19 vaccination required. May request medical or religious exemption if applicable.

Benefits and Perks: Supportive, fun and friendly team environment!

• Competitive Wages

• Vacation and sick leave

• Employer paid medical, dental, vision and life insurance

• Retirement 403b plan and supplemental insurance benefits

• 17 paid holidays plus paid birthday off & anniversary day and up to 5 days based on length of service

• BBS supervision, on-going clinical training and CEUs available

• Employee referral bonus

• Employee Assistance Program

• Employee discount programs to theme parks, movies, hotels and car rentals

• Paid educational leave

• Paid drive time and mileage reimbursement

• Eligible for Federal Student Loan Forgiveness

If you require reasonable accommodation of a disability in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to 323.242.5000, Ext. 1258 or by email to scardenas@shieldsforfamilies.org.

At SHIELDS for Families, our Diversity, Equity, and Inclusion (DEI) Committee promotes equity and inclusion within our programs, workforce, and the communities we serve. Our DEI Committee harnesses the power of our diverse workforce, utilizing their varied backgrounds and experiences to enhance our programs. By employing culturally sensitive and comprehensive service models, we aim to provide the best support possible to the families we serve.