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We are North Idaho’s premier provider of integrated medical, dental and behavioral health services. Our amazing care teams deliver world-class healthcare utilizing a patient directed, community-focused approach. Providing high quality, affordable Healthcare from the Heart is our passion. Our mission is to deliver a healthcare experience that provides hope, inspires change, and extends life for our patients and our community.

Top reasons to join our team:

• Our employees are mission – minded
• We are passionate about providing excellent patient care
• Community-focused
• Committed to a fun and supportive team environment
• We offer high-quality competitive employee benefits

Summary:

Responsible for directing and coordinating the overall functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, provider and other customer relations.

Minimum qualifications:

• Associates degree in business administration or related field. Bachelor’s Degree and/or Certified Coder preferred. 
• Five (5) years of Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system. 
• Two (2) years supervisory or management experience preferred, or any similar combination of education and experience.

Knowledge, Skills, and Abilities Required:

1. Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers and Medicare.
2. Working knowledge of CPT and ICD10 codes, HCFA 1500 and UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and the appeal process.
3. Possess excellent negotiation skills, including the tact required for securing payment or discussing patient’s finances.
4. Up to date with health information technologies and applications.
5. Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public.
6. Skill in developing, implementing and administering work processes.
7. Ability to supervise and train employees, to include organizing, prioritizing and scheduling work assignments to meet practice timelines.
8. Ability to communicate effectively in writing, over the phone, and in person.
9. Proficient in the Microsoft Office including Outlook, Word and Excel.
10. Be service-oriented with the ability to pay attention to details in a fast-paced environment.

Duties and Responsibilities:

1. Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up and reimbursement management.
2. Serves as the practice expert and go to person for all coding and billing processes.
3. Plans and directs patient insurance documentation, workload coding, billing and collections and data processing to ensure accurate billing and efficient account collection.
4. Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
5. Audits current procedures to monitor and improve efficiency of billing and collection operations.
6. Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines and requirements.
7. Analyzes trends impacting charges, coding, collection, and accounts receivable and takes appropriate action to realign staff and revise policies and procedures.
8. Ensures a monthly financial reconciliation between billing and accounting.
9. Keep up to date with carrier rule changes and distribute the information within the practice.
10. Supervises billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
11. Provides, oversees and/or coordinates training for new and existing billing staff on applicable policies, protocols, systems and procedures, standards and techniques.
12. Works in collaboration with the Revenue Cycle Manager on pertinent issues effecting organization wide billing and collections.
13. Heritage Health staff have an active role in our Patient Centered Medical Home model of care. This role is designated as part of the Heritage Health PCMH Care Team.
14. Regular and predictable attendance is an essential function of this position.
15. Performs other job-related duties as assigned.

Safety:

Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues.

Physical/Mental Requirements:

Required to stand, sit, and be mobile one-third to two-thirds of the time. They are required to use hands to finger, handle or feel over two-thirds of the time; while reaching with hands and arms occurs one-third of the day. Climbing or balancing, stooping, kneeling or crouching occur less than one-third of the time. Communicating by talking / hearing occurs over two-thirds of the day. Amount of time spent lifting or exerting force is about 50% for up to 10 pounds and less than one-third of the time up to 25 – 40 pounds. Rarely is there a need to lift more than 41 pounds. Must be able to manage efficient keyboard use, hear, see, speak and read.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to solve complex practical problems
• Positive interpersonal, communication & persuasion skills over the phone, computer & in person
• Must be able to simultaneously manage several objectives and assign priorities
• Deal with a wide variety of variables in situations where only limited standardization exists
• Ability to interpret a variety of instructions furnished in written or oral form
• Ability to work effectively under pressure to meet deadlines with a strong organization skill set for easy retrieval of information and to ensure competent closure of issues
• Ability to work overtime as needed, maintain alertness & meet the controlled substance policy.
• Good judgment and sound decision making and conflict management skills to inspire confidence from the customer
• Manage complex analysis and use deductive reasoning

Working Conditions:

Work is normally performed in a typical interior/office work environment in a clinic. Work may be demanding and chaotic at times. Exposed to patient population that will present a variety of contagious diseases, physical injuries, and emotional states of mind.

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