What are the responsibilities and job description for the Director, Billing, Coding & Compliance position at HOPCo?
At HOPCo, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
QUALIFICATIONS
- Bachelor’s degree or an equivalent combination of education and experience
- Minimum of five years of experience in a leadership role within a billing department in healthcare revenue cycle operations, coding, and medical terminology.
- Experience in professional and facility coding required.
- Experience working with multiple physician specialties, ASC, and hospitals preferred.
- Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that positively impacts others.
- AAPC Certification
ESSENTIAL FUNCTIONS
- Manages the day-to-day operations of the Site Billing, Coding, and surgery coding authorizations departments to optimize performance and quality levels while ensuring the most efficient use of resources.
- Monitor all aspects of billing activity and initiate appropriate corrective measures as needed. Communicates performance data and associated action plans to Senior Leadership.
- Identifies and implements processes to achieve key revenue cycle metrics including but not limited to Posted Charges, Suspended Claims, Rejection Percentage, Denial Percentage, and surgical coding authorizations.
- Analyze large volumes of data and provide financial analysis and regularly presents trends, movements, and status to Senior Leadership.
- Review billing work queues regularly to ensure that workloads are distributed evenly and that the department metrics are being met.
- Resolve complex patient, physician, and other issues when necessary.
- Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
- Supervises, trains, and orients and evaluates performance over assigned staff.
- Understands and stays abreast of payer requirements and changes within the industry. Provides training and oversight to staff to assure that these requirements are executed.
- Attends administrative meetings and participates in committees as requested.
- Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
- Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
The SR Director Billing, Coding & Compliance is responsible for coding compliance, charge entry, and coding surgery authorization management. Support increasing business profitability by effectively managing timely surgical coding authorizations, billing/charge entry, accurate coding, analyzing denials, rejections/seek the best approach to overturn, and reducing days in accounts receivable.
Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
#HOP
Salary : $43
