Director of Billing Services - Long Term Care
Director of Billing Services - Long Term Care
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
Symbria Rx is seeking a highly skilled and dedicated Director of Billing for Long Term Care to join our EMPLOYEEOWNED TEAM!
POSITION SUMMARY
The Director of Billing plays a critical leadership role in managing all aspects of pharmacy billing including Medicare Part A Managed Care Medicare Part D commercial and other thirdparty individual is responsible for operational oversight of claim adjudication billing and reimbursement activities leading a team of billing professionals ensuring compliance with payer requirements vaccination clinic billing and driving process improvement initiatives.
This position requires a seasoned billing professional who can make sound decisions build and lead teams deliver highquality customer support and streamline workflows for maximum efficiency and effectiveness. The ideal candidate is dependable dedicated and aligned with the organizations mission to deliver exceptional service to longterm care partners.
Responsibilities
- Lead manage and hold accountable the daytoday operations of the pharmacy billing department and team members.
- Oversee the full monthly billing cycle for Med A Part D commercial plans and Private pay to ensure timely and accurate delivery of invoices
- Oversee vaccine clinic billing to ensure accurate and timely submission
- Proactively address and resolve billing discrepancies payer denials and appeals both internally and externally.
- Act as liaison for obtaining thirdparty payer contracts
- Serve as the escalation point for internal staff and external client billing issues.
- Ensure departmental compliance with all payer requirements CMS regulations and company standards.
- Provide oversight and guidance to Pharmacy Audit Specialist
- Manages process of entering pricing into pharmacy information system
- Work with Pharmacy Billing Manager to establish metrics and ensure metrics are measured monitored and effectively utilized to hold employees accountable
- Build mentor and retain a highperforming team.
- Train new staff and implement crosstraining programs to increase department flexibility.
- Continuously assess and refine workflows for efficiency scalability and costeffectiveness.
- Develop track and report KPIs and quality metrics; use data to drive accountability and performance improvements.
- Collaborate crossfunctionally with operations clinical IT and finance to align goals and improve communication.
- Identify gaps in current processes and implement solutions with a focus on continuous quality improvement.
- Hold team members accountable to established protocols and intervene when deviation from process occurs.
- Participate in strategic planning and contribute to departmental goals budgeting and forecasting.
- Perform other duties as assigned.
Qualifications
- High school diploma or equivalent required; Associate or Bachelors degree in Business Accounting or related field preferred.
- Minimum of five 5 years experience in Long Term Care pharmacy billing with a strong emphasis on Medicare Part A Medicare Part D and private insurance reimbursement.
- Minimum of three 3 years of supervisory or managerial experience in a healthcare billing environment.
- Demonstrated ability to lead teams develop staff and manage department performance metrics.
- Ability to train mentor coach and delegate while holding staff accountable.
- Strong working knowledge of pharmacy billing platforms eHRs and payer portals.
- Exceptional problemsolving and decisionmaking skills with a keen eye for process improvement and efficiency.
- Outstanding customer service interpersonal and communication skillsboth written and verbal.
- Proficiency in Microsoft Office applications
PREFFERED QUALIFICATIONS
- Experience with ticketing systems (Jira FreshDesk ZenDesk etc..
- Proficiency in Microsoft Excel (including formulas filters and pivot tables).
- Knowledge of Medicare Part D & B billing
DIRECT REPORTS
- Pharmacy Billing Manager
- Pharmacy/ Third Party Audit specialist
- Adjudication Technicians
Why work for us
At Symbria our employees act like owners because we are owners! As one of the few 100 employeeowned healthcare providers our focus remains on delivering bestinclass services within our Pharmacy Rehabilitation and WellBeing operations which allows our clients to improve the lives and wellbeing of their patients and residents. Our teams utilize insights and analytics to drive better health outcomes for our partnered postacute and senior living communities while providing them with flexible service options.
Symbrias Core Values drive the way we partner with those clients their patients and residents and the way our diverse employeeowners work together:
- Integrity Honest Fairness and ethics
- Compassion Commitment to serving seniors
- Stewardship Maximizing mission and margin
- Innovation Striving to enhance our value to your organization
- Teamwork Working together unselfishly toward goals
As an employeeowner Symbrias success becomes your success. In addition we provide:
- Competitive pay aligned with market guidelines
- Full Benefits Package including very generous paid time off plans
- Professional liability coverage
- 100 employerfunded ESOP retirement plan
- 401(k) and Roth(k) plans
- Continuing education
- Credit union membership
All applicants will be afforded equal opportunity without discrimination because of race color religion sex sexual orientation marital status order of protection status national origin or ancestry citizenship status age physical or mental disability unrelated to ability military status or an unfavorable discharge from military service.
Required Experience:
Director
Employment Type
Full-Time
