University of Rochester Administrator II - 217752 in Rochester, New York
Eastman Dental Center
Full Time 40 hours Grade 055 EIOH Finance & Admin
8 AM-5 PM
Manages the Billing Department of the Eastman Institute for Oral Health (EIOH) under the general direction of the Chief Financial Officer and with significant latitude for independent judgment, is responsible for the billing operations of the Institute, comprising annual charges of over $40,000,000 in faculty practice, community, and resident clinical services. Supervises department billing staff, insurance credentialing function and patient scheduling staff (26 FTE’s), including hiring, training and performance evaluations. Reviews and synthesizes information from CMS, eMedNY and insurers related to relevant changes to determine, develop, implement and monitor policies and procedures to ensure accurate and efficient charge entry, payment posting, accounts receivable management and reporting. Accountable for ensuring compliance with federal, state and other regulations concerning dental and medical billing procedures and practices. Develops and maintains reports on billing activities and communicates results to Chief Financial Officer, EIOH Leadership, and as necessary, Department Chairs and faculty. Serves as liaison and represents the department with Medical Center Compliance, SMH Patient Accounts, HIM and other University departments and areas. Performs non-routine analyses on related issues and participates in various projects as directed by the Chief Financial Officer.
Supervision of Billing Staff
Supervise billing staff including hiring, training, and performance evaluations.
Provide leadership and training of staff on billing policies and third party contracts. Ensure compliance with federal, state and other regulations concerning billing policies and procedures.
Assign and monitor work flow to maximize efficiency. Provide opportunities for cross training and development of staff skills.
Determine, develop, implement, and monitor policies and procedures to ensure complete and efficient charge entry, payment posting and accounts receivable management.
Determine departmental review processes to insure compliance and productivity of billing staff.
Handle non-routine claim and payment issues.
Monitor accounts receivable and collection rates and take appropriate action to maximize reimbursement.
Serve as liaison to other University of Rochester departments and third party payers.
Defines organization structure required to meet departmental and hospital goals.
Reporting and Analysis
Develop and maintain reports and communicate the results of billing operations to the Chief Financial Officer.
Perform non-routine analysis on billing and revenue related issues.
Analyze billing systems and procedures and recommend changes for process improvements in order to maximize revenue. Update systems to keep current fee schedules and CDT/CPT/ICD10 codes current and billable.
Regulatory and Insurer Compliance
Review CMS, eMedNY and insurer regulations and policies to incorporate into dental and medical procedures and patient documentation as needed.
Train staff in proper billing and coding procedures and compliance issues related to third party billing.
Responsible for oversight of insurance credentialing responsible for the initial credentialing, and recertification of over 150 dentists in the organization. Ensures policies and procedures are in place to enable new and existing providers the ability to become credentialed with payers in a timely manner to ensure maximum reimbursement.
Works with Data Analyst to ensure billing activity reports for the Institute meet the needs of the Finance and Clinical departments and are done accurately and timely through the use of AxiUm and other data analytic software and various billing/accounting tasks. Ensure billing staff receives monthly reports on billing status/activity in each clinical department. Update and develop reports as necessary in conjunction with Data Analyst to meet the needs of the division on a monthly basis.
Develop and monitor departmental budget
Participate in and contribute to various projects as assigned by the Chief Financial Officer including monthly operation meetings and Institute initiatives.
Bachelor's degree and 5 years relevant experience including at least 2 years at a managerial level; or equivalent combination of education and experience. Master's degree, equivalent course work, or specialized experience in an appropriate field related to the assignment is desirable.
Working knowledge of billing systems and reporting systems preferred. Direct experience in dental and/or medical fee billing preferred. ADCA, CPC, CMBS and AAOMS credentialing preferred. Certification as a Certified Dental or Medical Billing Instructor desirable.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled