Director of Billing and Coding

Position Overview:

An exempt management position responsible for planning, directing and coordinating the direction and tactics for the Health Center’s reimbursement strategy. Oversees operation of the billing and UR department, which encompasses coding, charge entry, claims submission, payment posting, accounts receivable follow up, UR, and reimbursement management. Position is responsible for ensuring maximization of cash flow while improving patient, physician and other customer relations.

Essential Function:

· Ensures the activities of the billing operations within the Health Center are conducted in a manner that is consistent with overall department protocol, and are in compliance with federal, state and payer regulations, guidelines, and requirements.

· Serves as a principal liaison to staff and administrative team on day-to-day issues within the areas of accounts receivable operations

· Oversees the Supervision and Development of personnel, which includes work allocation, training and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.

· Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.

· Analyzes trends effecting charges, coding, collection and accounts receivable and takes appropriate action to realign staff and revise policies and procedures.

· Analyzes reports and performs audits to determine areas of improvement and determine appropriate plan of action.

· Provides advice and assistance to senior management in the planning, implementation and evaluation of modifications to existing operations, systems and procedures.

· Prepares the annual operating budget for the accounts receivable department for approval and integration into the overall budget for the operating unit; monitors department compliance with established fiscal parameters.

· Understands and remains updated with current coding and billing regulations and compliance requirements.

· Maintains a working knowledge of CPT and ICD-10 coding principles.

Location and Hours of Position

PHN Billing Department: 118 Vine Avenue, Sharon, PA 16146.

The general office hours for this position are Monday - Friday 8:30am - 5:00pm.

Compensation

This position is a salaried position, however, PHN recognizes certification, licensure, experience, education and site location when determining wage.

Qualifications:

· Bachelor’s degree, preferably in business administration or related field or a minimum five years of health care accounts receivable management.

· Knowledge of accounting principles and supervisory experience

· Minimum three years medical insurance/health care billing and collections with an understanding of medical billing rules and regulations.

· Knowledge of business management and basic business principles to direct the billing department.

· Advanced knowledge and understanding of medical billing and/or coding systems, as appropriate to the position.

· Broad-based knowledge of relevant insurance regulations and familiarity with Health Insurance Portability and Accountability Act.

Benefits

Choosing PHN means more than a job title; it's a holistic experience that nurtures every facet of your well-being and aspirations.

• Medical/Dental/Vision (Employee and Family plans available immediately upon start date!)
• Employer Paid Short Term disability
• Employer Paid Life Insurance
• Retirement Plan
• Paid Time Off
• 8 Paid Holidays
• College Savings Plan
• Fitness Center Membership Reimbursement
• ID Shield & Legal Shield
• Volunteer Time Off Program

The Network

The Primary Health Network is the largest Federally Qualified Healthcare Center (FQHC) in the state of Pennsylvania. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring that every individual has access to high-quality, compassionate and exceptional healthcare.

With the Joint Commission Accreditation, we adhere to the highest standards of safety and quality in healthcare, ensuring top-notch services that surpass industry benchmarks. Some additional achievements that exemplify our commitment to optimal health and wellness include:

Patient Centered Medical Home Accreditation

Age Friendly Care Health System Participant

HRSA Community Health Quality Recognitions in COVID-19 data reporting, advancing health information technology for quality, and continued implementation of the Primary Care Medical Home care model.

Ranked an impressive #5 in the Government & Non-Profit sector by Inspiring Workplaces of North America for 2023

Accessibility Support for Applicants

Primary Health Network is committed to providing equal access to employment opportunities.

If you experience difficulty accessing our careers site or completing an application, or if you require a reasonable accommodation due to a disability, please contact us at recruitment@primary-health.net. Our team will work with you to provide an accessible alternative application process.

Primary Health Network is an Equal Opportunity Employer (EOE)