Billing Manager

Job summary:  An exempt, management position responsible for directing and coordinating the overall functions of the billing department to ensure maximization of cash flow while improving patient, physician, and other customer relations. 

Manage, direct and supervise medical and dental billing operations and collections consistent with quality customer service, timely and accurate claims processing, and maximum reimbursement opportunities in accordance with organization goals.

Essential Duties and Responsibilities include the following.  Other duties may be assigned.

Responsible:

• Seek to understand and meet the needs of the customer through respectful, courteous and caring interactions with patients, families and other health professionals. Maintain strong and positive relationships with key clinic contacts including external vendors, insurance plan representatives and peer contacts in other community clinics.


• Know, understand and adhere to organizational policy related to the patient's rights for confidential care. Maintain strict confidentiality standards regarding patient financial information and promote and enforce strict confidentiality standards for billing department staff.


• Actively participates and works positively, flexibly and cooperatively in a team effort to accomplish the goals of the organization.


• Demonstrate effective, culturally sensitive communication skills and effectively communicate verbally and in writing with a variety of people.


• Recruit, train, and supervise business office staff in comprehensive operations of the medical billing and collections function. Evaluate staff performance and provide appropriate feedback and training as required.


• Oversee billing functions including correct coding, charge entry, claims processing and collections.


• Establish efficient processes for multi-site/program claims processing; work collaboratively with department managers, physicians and other staff to establish new/changing programs, or identify and resolve billing related issues.


• Manage technical operations of billing system, including data base maintenance, generation of reports, filing/resolution of claims, issuance of patient statements, and processing of payments.


• Assist in developing operating policies and procedures for the department in conjunction with the Chief Financial Officer; develop and execute an organization-wide accounts receivable management plan.


• Establish goals with measurable objectives for timely accurate filing of claims according to payer standards and reimbursement regulations.


• Develop and enforce credit and collection policies consistent with program and grant requirements; maintain system on ongoing review of open personal accounts receivable that minimizes bad debt and promotes use of the sliding fee program for eligible patients.


• Analyze and report trends impacting accounts receivable, and take appropriate action to address issues.


• Keep abreast of current billing regulations and compliance requirements.


• Participate in the development and monitoring of the annual department budget.


• Establish and maintain effective working relationships with key health plan/insurance contacts and the billing system vendor/centralized support staff.


• Conduct regular and ongoing coding education, auditing and training; participate in/lead initiatives to improve billing and collection processes.

Secondary:

• Conduct regular meetings with staff to ensure compliance with established practices; implement new policies, and keep staff abreast of changes.


• Promote a customer service focus/philosophy for billing and collection functions.


• Maintain professional affiliations and attend meetings that contribute to effective billing systems and business office functioning. Participate as appropriate with Neighborhood Health Care Network activities related to billing and systems practices.


• Participate in the development of financial and operational reports which promote complete and accurate information for clinic services.


• Performs other related duties as assigned.

Qualifications Requirements:  Ability to handle confidential material, in compliance with HIPAA Legislation. Skill in exercising initiative, judgment, discretion, and decision-making. Ability to operate a computer keyboard, copy machine and other office equipment with moderate speed and high accuracy. Strong written and verbal skills in person and telephone etiquette in problem-solving situations. Eyesight correctable to read numbers, policies and computer printouts or terminal. Hearing correctable to within normal range for telephone use and patient interactions. Working knowledge of revenue cycle areas of patient registration, charge capture, billing, accounts receivable and cash management. Knowledge of government and third-party insurance practices, and business office operations. Knowledge and understanding of state and federal laws, regulations and guidelines pertaining to medical billing. Knowledge of collections, accounts receivable and financial report technology and health care billing systems requirements. Ability to communicate effectively verbally and in writing with patients, vendors, insurance payers, other business contacts, and other employees. Ability to fully utilize EHR/practice management system billing software and effectively utilize technical support.

Education and/or experience: Certified Coding certificate required.  Bachelor’s degree in healthcare administration,

business, or related field preferred.  Experience in healthcare management a plus, 5-7 years of supervisory experience preferred.

Language Skills:  Ability to read, analyze, and interpret financial reports.  Ability to respond to common inquiries or complaints from customers and regulatory agencies.  Ability to effectively present information to top management.  High level of communication proficiency.

Mathematical Skills:  Ability to work with accounting concepts such as income and expense statements, budgets, and controls on cash such as into and out of COMC for deposit to the bank. Understanding of financial data analysis and reporting. Financial management.

Reasoning Ability:  Ability to define problems, collect data, establish facts, and draw valid conclusions. 

Other Skills and Abilities:  In-depth knowledge and full scope of information processing, telecommunications, and related technologies.  Time management, ability to set priorities and meet deadlines; strong interpersonal communication and leadership skills.  Ability to operate office equipment and computer skills required. Accounting, Corporate Finance, Reporting Skills, Analytical skills, Attention to Detail, Deadline-Oriented, Reporting Research Results, SFAS Rules, Organization, Confidentiality, Time Management, Data Entry Management. Problem solving. Decision making.  Knowledge and compliance with HIPAA and 340B requirements is required. Confidentiality of patient information is mandatory.

Physical Demands:  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This includes moderate physical effort consisting of occasionally lifting or moving over 35 pounds of weight.

Travel Requirement: To fulfill the responsibility of the position travel to all COMC locations may be required.  Employee must have valid Missouri driver’s license and availability of a motor vehicle. 

Work Environment:  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Knowledge of, and compliance with, HIPAA and 340B regulations is required. Confidentiality of patient information is mandatory.

The noise level in the work environment is usually moderate.

Hours are flexible as approved by the CFO with increased hours for weekends and evenings during special events.

About COMC:

Central Ozarks Medical Center has been providing quality health care in Central Missouri since 1979.  Central Ozarks Medical Center’s staff members are committed to leading the way to healthier communities.  COMC offers a wide range of services based on the needs of the communities we serve. We pride ourselves on offering high quality healthcare regardless of insurance status.

Our Mission

COMC is committed to leading the way to healthier communities by reducing barriers to care, ensuring access for all, and creating a positive working environment of engaged team members with a shared goal.

Our Values

At COMC, we use the following strategically anchored values to guide all our actions:

Selfless Service: We lead by example.

Approachable: We communicate openly.

Resilient: We enable and Inspire.

Passionate: We promote community.

Responsive: We take action.

Resourceful: We collaborate.