VP of Billing Services

The Vice President of Billing Services is responsible for the strategic planning and daily operations of the billing function with focus on promoting quality revenue management and productivity through the use of key performance indicators.  This position oversees all aspects of revenue management to include billing, coding, collections, bad debt management, denial management managed care contract performance and compliance with Medicare and state regulations and payor policies.  This leader must develop and maintain visibility and regular communication with clients, internal staff and the senior leadership team and will interact, influence and work with C-level executives of our clients.

Accountabilities

Lead all areas in revenue management to include billing, coding, collections, bad debt management, denial management, managed care contract performance and compliance with Medicare and state regulations and payor policies. 

Responsible for ensuring optimal revenue stream capture and actively driving and improving all key metrics of billing operations.

Establish a culture of employee engagement that will improve teamwork and employee retention.   Plans, develops, and implements in-service education program for assigned staff.

Develops and maintains appropriate policies, procedures and internal controls over accounts receivable.

Responsible for integrity of the billing system, provide management reporting and auditing. Set and monitor benchmarks to achieve the highest billing standards, quick adjudication, and high net revenue.

Identifies and implements modifications to the billing processes to ensure optimization of billing operations while maintaining compliance with government and insurance regulatory requirements.  Research and review federal state and industry references to ensure an in-depth understanding and application of industry and legislative standards and changes as it relates to billing and reimbursement.

Negotiate and manage the relationship with all outsourcing partners and hold vendors accountable to established key performance indicators. Develop relationships with insurance carriers at a high level to assist in problem resolution.

Maintain a current and thorough knowledge of related reimbursement operations issues and trends and utilizes such knowledge to enhance billing operations and revenue management.

Responsible for managing the entire department specific processes to ensure that both internal and external customers are supported.

Responsible for providing a leadership role to ensure timely collections and maximization of collections per agreed upon goals. 

Other duties as assigned.

Qualifications and Requirements:

Bachelor’s degree preferred, or related work experience
At least 10+ years of progressively increasing healthcare billing experience in large billing organization w/ multiple professional contracts

3-5 years of experience in leading a billing organization with high volume of transactions and have successfully accomplished and maintained leading edge key performance indicators in billing operations and revenue management.

In depth knowledge of Medicaid, Medicare and commercial insurance, ICD-9, CPT coding and A/R  management is highly desirable 

Demonstrated skills in problem resolution and proven track record in receivable and revenue management.
Proven leadership and influencing ability and outstanding, verbal, written and interpersonal skills.