Job description
Position Responsibilities/ Essential Duties:
- Directs the planning, organizing, and coordinating of all administrative and operational activities within the CCWV Behavioral Health Billing Department.
- Develops long-range and short-term goals, objectives, plans, and programs and ensures their implementation.
- Assists CFO & Controller in planning, developing, and controlling budgets, including personnel, capital equipment, and operations of the CCWV BH Billing Dept.
- Evaluates impacts of innovations and changes in program, policies, and procedures within the department.
- Designs and implements systems and methods to improve accessibility of data and processes. Identifies, assesses, and resolves problems.
- Prepares administrative reports as requested.
- Monitors acceptable accounts receivables associated with charges generated.
- Perform reviews, audits, and the coding of BH medical records to ensure that appropriate diagnostic codes and modifiers are used in accordance with Generally Accepted Medical Coding Guidelines and both ICD-9, ICD-10 guidelines, and CPT codes.
- Works with behavior health providers or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
- Oversees and monitors the compliance of CCWV with universal coding standards.
- Develops and coordinates educational and training materials regarding the elements of the BH coding program, such as appropriate documentation and accurate coding, to all appropriate personnel, BH physicians, mid-levels, and ancillary departments.
- Keeps updated on BH billing and benefit changes for third party insurance carriers.
- Keeps updated on third party billing requirements and changes for insurance types.
- Reviews claim denials and rejections pertaining to BH coding and BH billing and medical necessity issues and, when necessary, implements corrective action plan, such as educational programs, to prevent similar denials and rejections from reoccurring.
- Maintains confidentiality of all information.
- Completes work within authorized time to assure compliance with departmental standards.
- Demonstrates knowledge of, and supports, office mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
- Performs other duties as required.
Qualifications:
- Five years of BH Billing and professional coding experience preferred.
- Bachelor's degree in related field preferred.
- Extensive knowledge of coding principles and guidelines, CPC preferred
- Extensive knowledge of medical/technical and professional services reimbursement systems.
- Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for professional and technical services.
- Strong managerial, leadership, and interpersonal skills.
- Excellent written and oral communication skills.
- Excellent analytical skills.
Education
Required- High School or better
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