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Director, Patient Financial Services

  • Full Time
  • Waterville, ME
  • This position has been filled

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 

REQUIRED EXPERIENCE:

  • Staff Management experience
  • Contracting & Payor relations background
  • Understanding of billing processes and accounting principles
  • Billing software
  • Extensive Excel and/or other database use 

REQUIRED KNOWLEDGE:

  • Knowledge of third-party reimbursement preferred
  • Knowledge of insurance payor contracting
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