Purpose of Position – Oversees all Billing Operations to ensure accurate, timely and compliant reimbursement from Medicaid and other payers. This role will independently manage the Billing Operations staff, work closely with internal teams and serve as the subject matter expert for Billing Operations.  Responsible for the analysis, design, implementation, and follow-up of billing practices and resolution.  

 

Essential Duties/Responsibilities

 

• Provides daily supervision and direction to Billing Operations staff that are responsible for the billing process. 
  • Provides staffs consultation on day-to-day decisions that may be time sensitive.
  • Develops, implements, and enforces billing policies and directly oversee billing accuracy.
  • Responsible for selection, hiring, training, and day-to-day management of Billing Operations team.
  • Responsible for performance management and development of Billing Operations team.

 

• Responsible for all billing practices including:
  • Ensures timely billing out of Imagine!’s Electronic Health Record (EHR) system.
  • Ensures all billing meets federal false claims criteria.
  • Ensures unbilled services and denied billing are researched and resolved within timely filing practices and deadlines.
  • Claims testing and audits.

 

• Responsible for developing and managing billing policies and practices.
  • Responsible for keeping up to date on state Medicaid billing-related policies and communicating and implementing changes as necessary.
  • Responsible for collaborating with other departments on system changes and process improvements.

 

• Acts as Electronic Health Records (EHR) Subject Matter Expert. 
  • Responsible for monitoring and improving EHR practices for billing.
  • Responsible for coordinating with internal teams on Imagine’s EHR system.
  • Coordinates with IT on system changes to the EHR that are needed for compliance or billing.

 

• Responsible for analysis of billing data.
  • Responsible for generating monthly billing reports for review by Controller and CFO.
  • Responsible for generating analytical data on billing.

 

• Other duties as assigned.

 

 

Job Qualifications

 

Knowledge, Skill, and Ability:	Advanced skill and ability with Excel. Ability to generate succinct and actionable reports from various data sources. Ability to analyze billing data and make recommendations for process improvement. Ability to work under pressure to accomplish time-sensitive tasks. Effective written and verbal communication skills with individuals and groups at all professional levels. Ability to work with cross-department teams on complex projects. Ability to develop cohesive processes from regulatory documentation. Demonstrated organizational and time management skills. Ability to work independently and prioritize tasks/goals for self and teams. Ability to work effectively with various technologies including word processing software, internet-based databases, internal and state specific systems, etc. Effective problem solver. Ability to handle sensitive information and maintain confidentiality. Moderate understanding of IDD or other Medicaid services and billing. Basic understanding of or ability to learn state survey practices and regulations. This position requires use of a personal mobile device such as a smartphone or tablet.
Training/Education:	Bachelor’s degree preferred, preferably in accounting, finance or business.
Experience:	Minimum of 2 years experience with billing and/or long term care services required. At least 3 years’ supervisory experience in managing a finance or accounting team. Therap or other Electronic Health Records system experience preferred. Medicaid billing experience a plus.
Working Environment/Physical Activities	Effective with shifting roles, responsibilities, and expectations in a changing environment. Ability to work effectively under the pressure of deadlines. Work is primarily performed in a standard office environment.

 

 

Fine Print:

• This above is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.  
• Employment at Imagine! is at-will, meaning that either the employee or Imagine may terminate the employment relationship at any time, with or without cause or notice.
• Imagine! is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, protected veteran status, or any other legally protected status. We are committed to fostering an inclusive and diverse workplace.