Requirements of the Billing Manager:
- Associate’s degree in business administration or related field, or 5+ years of healthcare experience (preferably in OB/GYN or Women’s Health).
- 1+ years of previous management experience required.
- Certified medial biller preferred. Certified medical coder is a plus.
- Thorough understanding of medical billing, collections, and payment posting, revenue cycle, third-party payers, Medicare; strong knowledge of Maine and Federal payer regulations.
- Working knowledge of CPT, ICD-9, and ICD-10 codes, claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal processes.
- Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers.
- Possess excellent negotiation skills, including the tact required for securing payment or discussing patients’ finances, and enjoy working in a health care setting.
- Up to date with health information technologies and applications
- Excellent organizational, analytical and problem-solving skills.
- Ability to manage multiple priorities in a fast-paced environment
- Ability to interpret payer contract and reimbursement policies.
- Proficiency in Microsoft Office and experience with electronic health record and practice management systems
- Ability to commute to the Scarborough, ME office four days a week.
Benefits of the Job:
- Pay in the range of $80,000 - $85,000, commensurate with experience
- Generous PTO and paid holidays
- Retirement with employer contribution
- Medical insurance with vision benefit coverage
- Dental insurance
- Flexible Spending Account
- Employee Assistance Program
- 4-day work week
Responsibilities of the Billing Manager:
- Oversee the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, collections, and reimbursement management.
- Document and track billing denials. Develop an action plan to address the denials.
- Serve as the practice expert and go-to person for all coding and billing processes.
- Analyze billing and claims for accuracy and completeness; follow up with billers on work queues or pending claims.
- Review and approve billing refunds.
- Maintain contacts with other departments to obtain and analyze additional patient information to document and process billings.
- Work closely with providers and clinical staff to resolve coding and documentation issues.
- Prepare and analyze accounts receivable reports and insurance contracts with the Chief Financial Officer. Collect and compile accurate statistical reports.
- Audits current procedures to monitor and improve efficiency of billing according to the OIC Compliance Plan.
- Analyzes trends impacting charges, coding, collection, and accounts receivable, and takes appropriate action to realign staff and revise policies and procedures.
- Keep up to date with carrier rule changes and distribute the information within the practice.
- Perform physician credentialing actions.
- Maintain a library of information/tools related to documentation guidelines and coding.
- Attend webinars and seminars to stay updated on insurance changes.
- Develop and maintain billing policies, procedures and workflows.
- Ensure compliance with federal, state and payer-specific regulations.
- Oversee the effective use and ongoing maintenance of the practice management system within the EHR