Director of Patient Billing, Bureau of Budget and Revenue - 394048 - NYPD Recruit
: $81,970.00 - $157,490.00 /year *
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Job Description The New York City Department of Health and Mental Hygiene, a recognized leader and innovator in public health and mental hygiene services nationally and internationally, seeks a dynamic Director of Patient Billing to join its challenging, fast-paced Division of Finance. The Division of Finance has central responsibility and authority for policy analysis, program development, performance tracking and improvement, financial management, revenue maximization and technical assistance. The Director of Patient Billing is responsible for ensuring DOHMH's implementation and adherence to all Articles of Public Health Law with respect to patient billing, including, but not limited to Article 28, Article 31, and Article 36 for clinical and non-clinical services rendered to clients by the Department in Diagnostic and Treatment Centers and within the community.
DUTIES WILL INCLUDE BUT NOT BE LIMITED TO: --Assume management and oversight for the daily billing processes and functions including the accuracy and timeliness of charge entry, claims submission, follow-up, account adjudication, payments to community-based clinicians for the provision of higher-value care, and provider enrollment/credentialing in underserved and low-income communities. -- Optimize existing Revenue Cycle Management System (RCMS) and supervise the successful implementation of the new RCMS by utilizing four key performance indicators (Service-to-payment velocity, days not final billed, charge trends and denial rates) to assess for the successful transition of Electronic Health Records (EHR) from DOHMH s Ambulatory clinics, including our Tuberculosis, HIV and Sexually Transmitted Infection (STI) Clinics that provide healthcare services for underinsured and underserved patients from low-income families. --Work closely with all stakeholders within the Agency to manage process, people, and technology in the pursuit of optimum revenue cycle management functionality in compliance with applicable Articles of Public Health Law, including, but not limited to Article 28, Article 31, and Article 36. --Ensure compliance to acceptable coding and billing practices as designated by the Center for Medicare and Medicaid Services (CMS), including but not limited to operating certificates, certificates of need, credentialing of community-based healthcare sites and providers, Ambulatory Health Care Facility Costs Reporting. --Provide requirements for information required in Electronic Health Records to sustain appropriate billing practices and revenue optimization. --Reconcile and record accounts receivables within the general accounting ledger Financial Management System (FMS) to ensure the accurate posting of Medicaid, Medicare, Managed Care, third-party, and self-pay revenue to the general ledger. --Maintain thorough working knowledge of all aspects of billing and collections, including billing rules and regulations; collection practices; electronic billing processes, including Electronic Medical Records and Revenue Cycle Management Systems (RCMS); CMS 1500 form requirements; diagnosis and procedure coding; and applicable county, State, and Federal requirements. --Provide training and technical assistance on the implementation of new fiscal operational systems and agency-wide policies. --Manage the billing analysts to ensure that billing and collection activities are accurate and timely. --Institute and maintain the organization's billing policies and procedures, ensuring communication of these throughout the Agency. --Make and record observations on the progress of fiscal and operational analysis and the expected impact of proposed City, State and Federal legislative policies. --Conform to all applicable HIPAA, billing compliance, and safety policies and guidelines. --Develop denial protocols and templates for successful appeals. --Analyze denial inventory and denial reason codes to identify root cause issues that prevent payment of services and identify payer trends. --Ensure proper review of patient claims is performed. --Communicate with the appropriate agencies to ensure collections are timely and accurate. --Manage and conduct quality reviews of staff to ensure desired productivity and quality are achieved. --Monitor billing accuracy and timeliness to identify appropriate corrective actions, training and systems modifications. Performs random sampling of staff work, documents, and takes appropriate action. --Prepare reports for the Executive Management Team, auditors, and other interested parties regarding cash flow, site utilization, annual cost report, and other reports as requested. --Assist with other Finance related duties/projects as assigned. Minimum Qual Requirements 1. A baccalaureate degree from an accredited college or university and five years of full-time paid experience acquired within the last fifteen years, of supervisory or administrative experience including handling of business promotion or urban economic problems, at least 2 years of which must have been in a managerial or executive capacity with primary focus on business promotion or urban economic planning; or
2. A satisfactory equivalent combination of education and experience. However all candidates must have 2 years of managerial or executive experience as described in \"1\" above.
Appropriate graduate study in an accredited college or university may be substituted for the general experience on a year-for-year basis. All candidates must have a four-year high school diploma or its equivalent approved by a State's Department of Education or a recognized accrediting organization. Preferred Skills 1. B.A./B.S. in a related field. 2. Must be an AAPC Certified Professional Coder (CPC) and/or AHIMA Certified Coding Specialist. 3. Minimum of 5 years of experience in Healthcare Administration, physician billing, Revenue Cycle Management, and/or third-party payer environment. 4. Demonstrated skills in A/R management, problem assessment, and resolution and collaborative problem solving in complex, interdisciplinary settings. 5. Proficiency in health insurance billing, collections, and eligibility pertaining to commercial and managed care, and self-pay reimbursement concepts and overall operational impact. 6. Working knowledge of full scope revenue cycle management process; Patient registration, billing, payment posting, denial tracking/resolution, accounts receivable, local/state/federal regulations, medical terminology, and payer contract familiarity. 7. Extensive experience with implementing and maintaining billing systems. 8. Strong coding knowledge and understanding of ICD-10; certified coder.
1. Ability to work collaboratively with culturally diverse staff, strong customer service skills, demonstrating tact and sensitivity in stressful situations. 2. Ability to work independently and follow through and handle multiple tasks simultaneously. 3. Ability to communicate effectively in both oral and written form. 4. Must be motivated individual with positive and exceptional work ethic. Knowledge of computer systems, including use of spreadsheets and database programs. Excellent analytical and problem-solving skills. 5. Ability to educate and train all levels of professional staff. 6. Supervisory experience Additional Information **Appointments are subject to final approval by the Office of Management & Budget**
**IMPORTANT NOTES TO ALL CANDIDATES:
Please note: If you are called for an interview you will be required to bring to your interview copies of original documentation, such as: A document that establishes identity for employment eligibility, such as: A Valid U.S. Passport, Permanent Resident Card/Green Card, or Driver s license.
Proof of Education according to the education requirements of the civil service title.
Proof of Address/NYC Residency dated within the last 60 days, such as: Recent Utility Bill (i.e. Telephone, Cable, Mobile Phone)
Additional documentation may be required to evaluate your qualification as outlined in this posting s Minimum Qualification Requirements section. Examples of additional documentation may be, but not limited to: college transcript, experience verification or professional trade licenses.
If after your interview you are the selected candidate you will be contacted to schedule an on-boarding appointment. By the time of this appointment you will be asked to produce the originals of the above documents along with your original Social Security card.
The federal government provides student loan forgiveness through its Public Service Loan Forgiveness Program (PSLF) to all qualifying public service employees. Working with the DOHMH qualifies you as a public service employee and you may be able to take advantage of this program while working full-time and meeting the program s other requirements.
Please visit the Public Service Loan Forgiveness Program site to view the eligibility requirements:
To Apply Apply online with a cover letter to In the Job ID search bar, enter: job ID number # 394048.
We appreciate the interest and thank all applicants who apply, but only those candidates under consideration will be contacted.
The NYC Health Department is committed to recruiting and retaining a diverse and culturally responsive workforce. We strongly encourage people of color, people with disabilities, veterans, women, and lesbian, gay, bisexual, and transgender and gender non-conforming persons to apply.
All applicants will be considered without regard to actual or perceived race, color, national origin, religion, sexual orientation, marital or parental status, disability, sex, gender identity or expression, age, prior record of arrest; or any other basis prohibited by law. Residency Requirement New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.