Director Of Billing
CurrentIdentify denial trends from both front- and back-end claim denials and determine the correct procedure to get maximum return. Identify changes in payer guidelines to maintain compliance. Update & maintain multiple RCM systems as needed, including mapping new insurance payers, physicians, clinics, and updating guidelines for diagnosis & procedure codes. Ensure all systems are communicating for importing patient information and exporting charges. Create and assign login information for employees in all payer and client portals. Credential all new physicians/clinic with hospitals and insurance payers & recredential when needed. Analyze reimbursements to determine underpayments or overpayments. Review, validate, and process all month-end client bill only invoices. Maintain fee schedule for standard and client charges, updated quarterly. Resolve complex billing issues with payers and clients. Code and enter charges for facility clients. Prepare and transmit weekly patient statements, in-house collection letters, and submit report to outside collection agency for outstanding balance. Manage daily payments from patients, clients, and payers including but not limited to, pull daily deposit information, post payer remits and patient checks, calculate all remits and payments, and process overpayments. Maintained client database regarding covid testing and emailed encrypted version to clients with invoices. Develop and maintain a proper intake process to prevent invalid patient orders to move into the lab without the necessary documentation for the Oncology department. Assist Oncology teams with developing panels according to payer guidelines, determine payable reimbursement, and testing the initial manual pre-certification process. Daily communication via calls, emails, and meetings with upper management with all aspects of client issues, credits, payment posting errors, incorrect charges & balances.
