Director of ASC Billing

The Director of ASC Billing will have oversight of the Billing Team to ensure the ASC’s claims are posted, coded and processed accurately and in a timely manner. Furthermore, the Director of Billing will track claims, manage the claims process as well as optimize operational performance and deliver excellence by adhering to the Mission and Values of the company. This leader will maintain a positive working environment while upholding a strong example of workmanship and job execution.

DUTIES AND RESPONSIBILITES

• Ensures personal and team billing activities are completed timely and accurately.  
• Complete provider billing by the 5th workday of each month to meet the provider payroll deadlines. 
• Executes billing within 48 business hours of receiving post operative notes, implant invoicing and clarification of billing details as needed.
• Gets proactively involved with team members and staff on billing disputes to address these problems face-to-face and get positive results quickly.
• Maintains strict confidentiality and adheres to all HIPAA guidelines.
• Proactively recommends continuous improvements to maximize efficiency and accuracy of existing systems and processes.
• Assists and/or coordinates training of new employees, schedules, processes, etc.
• Effectively communicates with insurance companies, law firms, providers and patients as needed.
• Handles and/or coordinates assigned special projects.
• Oversees Full Revenue Cycle Management to ensure efficient and effective handling of all billing processes from processed claims to final payment, including regular audits to maintain high standards of accuracy.
• Leads appeals process by reviewing and responding to all denied claims, strategizing to overturn denials, and maintaining a high success rate in claim appeals and coordination of the peer-to-peer process.
• Ensures accurate and compliant coding practices within the team, staying updated with the latest coding standards and guidelines to prevent billing errors and denials.
• Oversees billing processes for major medical / commercial insurance, ensuring claims are processed in accordance with specific insurance policies and procedures.
• Stays current with Medicare Guidelines and rates, ensuring the team is well-informed and compliant in all aspects of Medicare billing and reimbursement practices.
• Manages Texas Worker’s Compensation claims, ensuring accurate and timely processing in accordance with state-specific guidelines and requirements.
• Supervises ASC Facility Billing, ensuring all aspects of ambulatory surgery center billing are handled efficiently, accurately, and in compliance with regulatory standards.
• Familiar with the prior-authorization processes to ensure claims are approved for payment. 
• Regularly reviews and updates billing procedures and guidelines for each area, ensuring a comprehensive understanding and adherence across the team.
• Provides adequate reporting and summaries to the executive team on a weekly, monthly, and quarterly basis. 
• Coordinates and assures collections of co-pays and patient balances.
• Performs all other duties as assigned by supervisor. 

Requirements

Education & Experience:

Associate or bachelor’s degree in accounting or related field.

• Highly experienced working with executive leadership.
• 5-10 years in a surgical and/or medical setting.
• 3-5 years of Ambulatory Surgery Center billing and coding experience is a must.
• 1-3 years of prior management experience (preferred) or the ability to receive management training to further develop people and management skills.
• 3+ years’ experience leading a billing team.
• Billing/coding credentialing highly preferred

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.

Must be able to lift 10-15 pounds at times.

KEY COMPETENCIES

• Ability to handle complex billing issues.
• Ability to successfully train, lead, and coach staff.
• Effective time management including the ability to multi-task and meet deadlines in a fast-paced environment.
• Ability to communicate effectively with staff, management, and customers to get what you need to succeed.
• Ability to handle confidential and sensitive information in a professional manner.
• Effective task delegation and follow-up qualities are essential.
• Excellent organizational skills.
• Excellent knowledge of MS Office.
• Good, practical experience with general office equipment.

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid Time Off
• Vision insurance
• Tuition Reimbursement