What are the responsibilities and job description for the Director, Billing, Coding & Compliance position at The Center for Orthopedic and Research E?
Job Description
Job Description
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.
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