Kennebec Behavioral Health, a comprehensive mental healthcare center in Central Maine and one of Maine’s Best Places to work in 2022, is seeking a Director of Patient Financial Services. The primary role of the position is to provide direct oversight to a department of six staff and to oversee the delivery of all billing and related services to clients and/or appropriate 3rd party payors. The Director also ensures that the credentialing for all licensed providers is completed in a timely manner.
Responsibilities will include:
Providing oversight to the Patient Financial Services Department staff to include:
- Provide ongoing education, training and support to team members
- Ensure workload is evenly shared by all staff and that staff are appropriately cross trained
- Provide support to improve or streamline business functions
- Ensure all billing, payments and reports are completed at end of each month.
Acting as a resource to management and clinical staff regarding billing requirements, provide a channel for communication and to ensure efficiency and compliance
- Monitor and ensure program compliance with payor requirements.
- Maintain quality assurance process for program evaluation.
- Collect and assemble all data as required for contracts, research, analytic, and internal reporting measures.
- Mediate and resolve issues and concerns of KBH staff, Insurance carriers and clients.
- Respond to management requests for data timely and accurately
- Work directly with IT Department for System and/or billing changes or issues
- Manage our Billing Clearing house and online credit card process.
- Understanding of medical coding nomenclature and process
Providing supervisory oversight to the Coordinators for Credentialing and Managed Care
- Develop tracking and reporting tools to reduce denials and maximize authorizations
- Work with Department of Health and Human Services for authorization for outstanding services.
- Guide clinical staff in following managed care policies and procedures.
- Ensure all requirements are met for new hires to be able to bill insurers
- Ensure confidentiality and security of licensing and financial records related to the process
- Ensure that all communications and requests of new providers meets insurer & KBH standards.
- Ensure Agency and Provider recredentialing standards and enrollments for all insurances are kept current.
EDUCATION: Associates degree or higher and a minimum of 5 years equivalent work experience
- Staff Management experience
- Contracting & Payor relations background
- Understanding of billing processes and accounting principles
- Billing software
- Extensive Excel and/or other database use
- Knowledge of third-party reimbursement preferred
- Knowledge of insurance payor contracting