Director of Medical Billing and Coding Operations

Job Overview: We are seeking a strategic and experienced leader to oversee and manage all aspects of our medical billing and coding operations, including a remote team of billing and coding professionals spread across the country. The Director of Medical Billing and Coding Operations will be responsible for ensuring the efficiency, accuracy, and compliance of medical billing, claims management, and coding services, with a focus on improving revenue cycle performance. This role requires a keen understanding of the healthcare billing process, coding standards, experience managing remote teams, and a commitment to maintaining the highest level of compliance and accuracy.

Key Responsibilities:
Billing Services:
Oversee the entire billing cycle, including preparing and submitting claims to insurance companies and managing claim denials and rejections, optimizing processes for remote team collaboration.
Develop and implement strategies for efficient insurance follow-up to ensure timely reimbursement for unpaid or denied claims, adapting communication strategies for a remote workforce.
Supervise payment posting, ensuring accurate recording of payments from insurance companies and patients, and reconciliation of accounts, implementing quality control measures for remote staff.
Manage a geographically dispersed team of billing specialists, ensuring quality control, adherence to company standards, and effective communication across locations.

Coding Services:
Supervise and support the accurate application of ICD and CPT codes to medical records to ensure correct billing and insurance claims, providing remote support and training as needed.
Ensure that coding practices comply with industry standards, regulations, and best practices, maintaining a strong focus on minimizing errors and preventing fraud, implementing audit processes suitable for remote work.
Develop and lead training programs for coding staff, utilizing online resources and virtual training sessions to keep them up-to-date on new coding procedures and regulatory changes, catering to the needs of a remote team.
Compliance and Risk Management:
Ensure all billing and coding practices adhere to healthcare regulations, insurance provider requirements, and internal policies, adapting compliance processes for remote operations.
Perform regular audits of billing and coding processes to identify potential issues, and implement corrective actions as necessary to ensure compliance and reduce risk, utilizing technology to facilitate remote audits and monitoring.
Leadership and Team Management:
Lead and mentor a remote team of billing and coding professionals, fostering a culture of collaboration, accountability, and continuous improvement, utilizing virtual communication tools to connect with team members.
Develop performance metrics and KPIs for the team to monitor productivity and efficiency, adapting metrics for remote work and individual locations.
Collaborate with other departments, including healthcare providers and administrative teams, to ensure seamless operations and communication, utilizing technology to facilitate communication across locations.
Address the specific challenges of managing a remote team, including communication, motivation, performance management, and team cohesion.

Qualifications:
Bachelor's degree in Healthcare Administration, Business Management, or related field (required).
Certification in Medical Billing and Coding (e.g., CPC, CCS) is preferred.
Proven experience in medical billing and coding, with at least 5 years of leadership experience in a healthcare setting, including experience managing remote teams.
In-depth knowledge of ICD, CPT, and HCPCS codes, along with healthcare insurance regulations.
Strong understanding of billing systems, payment posting, claims management, and insurance follow-up.
Excellent leadership, communication, and problem-solving skills, with a focus on virtual communication and remote team management.
Ability to manage geographically dispersed teams and collaborate with cross-functional departments.

Additional Skills:
Familiarity with electronic health records (EHR) systems and medical billing software.
Knowledge of regulatory compliance frameworks, including HIPAA and CMS guidelines.
Strong analytical and organizational skills with attention to detail, adapting organizational strategies for remote work.
Experience with remote team management tools and technologies.
Reports to: Chief Financial Officer (CFO) or Executive Director