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Director, Billing & Reimbursement

  • Job ID: 933872049
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Home Healthcare
  • Department: Billing/Ins Ver/Auth
  • Location: 300 Northepoint Circle, Seven Fields PA 16046
  • Union Position: No
  • Salary Range: $0 / hour

Description

Purpose:
The Director, Billing & Reimbursement provide direction to the insurance and billing departments of UPMC Home Healthcare.

Responsibilities:
  • Responsible for oversight of the monthly accounts close process, resulting in timely delivery of accurate revenue data to the CFO and of patient billing within established time frames.
  • Responsible to develop, revise and implement procedures so that appropriate submission, billing and payment cycles of patient accounts can be maintained consistently in all business units.
  • Responsible to identify, develop and participate in process improvement opportunities within the home health agency that will enhance the quality of service we provide.
  • Responsible to prepare reports and proposals, and recommend actions, including training programs where appropriate for internal and external customers.
  • Research, evaluate, and summarize impact of regulatory changes or implementation of new rates or methodology as directed by Senior Management.
  • Responsible to implement the financial policies and procedures that relate to receivable management to ensure established collection targets are met and receivables are maintained at an acceptable DSO.
  • Focuses on customer service and continually strives to perform the duties of their job in a manner that will result in optimal patient satisfaction.
  • Responsible to participate in external and internal audits as they relate to billing functions.
  • Responsible to ensure all policies, reports, schedules, registers and logs required of the department are properly maintained and issued as required.
  • Responsible to monitor the cost effectiveness and adherence to budget of department.
  • Work with internal audit and third-party auditors (when applicable) including, but not limited to, data supply, departmental contractual methodologies, reimbursement structures for all lines of business, claims pricing and / or resolution, and implementation or dispute of audit findings.
  • Responsible to supervise and direct activities of billing, collections and insurance verification staff to ensure consistent application of best practice, productivity and adherence to internal controls for billing compliance.

Qualifications

  • Bachelor's Degree in Accounting, Finance, or Business Administration required.
  • Five (5) years in health care reimbursement/revenue cycle and 2 years of experience in a leadership role required. 
  • Strong automated billing and health care accounts receivable management preferred. 
  • Travel: Position requires travel to various office sites, valid PA drivers' license and proof of auto liability required.

Licensure, Certifications, and Clearances:
Certification as a Manager of Patient Accounts under the Healthcare Financial Management Association preferred.

  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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       Current UPMC employees must apply in HR Direct

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