Description

The Billing and Procurement Specialist is a key driver of efficiency within the Community Services Department, expertly managing and coordinating billing processes, procurement operations, and contract management. This role demands a thorough understanding of healthcare billing practices and regulations, coupled with a strong focus on optimizing team productivity. The specialist is responsible for ensuring that each team member's individual productivity goals align with overall billing hours, enhancing both departmental performance and service delivery efficiency.

Essential Functions:

The following duties are normal for this position. The omission of specific statements of the duties does not exclude them from the classification if the work is similar, related, or a logical assignment for this classification. Other duties may be required and assigned. 

• Manage the entire cycle of healthcare billing, from claim creation to payment reconciliation, ensuring compliance with medical coding and insurance regulations.
• Develop and maintain policy, protocols, and procedures that adhere strictly to healthcare regulations and standards to ensure consistency and continuity.
• Analyze billing systems and reports, identifying and resolving discrepancies, and implementing improvements to enhance accuracy and efficiency.
• Coordinate with clinical staff to verify that services are captured accurately and billed promptly.
• Handle communications with insurance companies to resolve billing issues and ensure timely payment.
• Manage the procurement lifecycle for goods and services required by the Community Services Department, from requisition to receipt.
• Negotiate with vendors and suppliers to secure the best prices and terms, maintaining quality and adherence to budgets.
• Regularly evaluate supplier performance to ensure compliance with contractual terms and conditions and to foster strong vendor relationships.
• Develop and administer contracts for services, supplies, and equipment, ensuring that all contracts support the Community Services’ needs and compliance requirements in partnership with Procurement Department.
• Monitor contract execution, ensuring that all parties meet their obligations and that any issues are resolved swiftly to prevent service disruptions.
• Manage clear productivity targets for billing operations and monitor individual and team performance to ensure these targets are met.
• Implement productivity tools and techniques to streamline workflow, reduce wasted time, and increase the accuracy of billing and procurement tasks.
• Develop and maintain detailed records of all billing transactions and procurement activities to ensure transparency and compliance with auditing standards.

• Keep abreast of changes in healthcare billing regulations and industry best practices to ensure ongoing compliance.
• Analyze financial data related to billing and procurement to identify trends, forecast needs, and control costs.

Additional Functions:

• Conduct regular training and development sessions for team members to enhance their skills and knowledge in billing and procurement processes.
• Prepare for and participate in internal and external audits, providing all necessary documentation and explanations regarding billing and procurement practices.
• Attends and participates in a variety of meetings, conferences, trainings, and workshops for professional development and to obtain best practices for improving knowledge, skills and abilities.
• Operates within budget constraints.

Qualifications

• Bachelor’s degree in Finance, Accounting, Healthcare Administration, or a related field.
• At least 3-5 years of experience in healthcare billing and procurement, particularly in a mental health or social work setting.
• Professional certification in medical billing or healthcare procurement (e.g., Certified Professional Biller, Certified Supply Chain Professional) is highly preferred.
• In-depth knowledge of healthcare billing, including ICD-10, CPT coding, and insurance claims processing.
• Proficiency in medical billing software and electronic health record systems.
• Strong negotiation skills with a track record of securing cost-effective contracts

Additional Requirements/Conditions of Employment:
Successful results of pre and continued employment assessments including fingerprinting, drug testing, medical examinations and background check(s).

Step Forward is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the Agency will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.