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.

Total Rewards

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Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.