Billing Manager

THIS IS AN ON-SITE POSITION.

PURPOSE STATEMENT

Under direction of the Director of Patient Financial Services (PFS), the Billing Manager, is a working manager that participates in the activities of the Billing Department; supervises a staff assigned to bill and to collect patient accounts; participates in activities at a more complex level or as workload or other circumstances may require. The Billing Manager is accountable and responsible for the daily operations of all staff who are assigned to the department. Supervise operations of the department to ensure accuracy and cost-effective department performance in accordance with organizational goals and priorities. This position is responsible for knowing all the job functions under the Billing department position that report to this position and must be able to perform the functions with efficiency and high quality at any time. The primary goals of this position are; maximizing cash, minimizing denials and preventing aging of receivables beyond the acceptable time frame while creating an atmosphere that educates and develops staff members.

ESSENTIAL FUNCTIONS

• Provide leadership and oversight of billing representatives – Billing QA Specialist, Clearinghouse Specialist, Denial Specialist, Insurance Follow Up, Revenue Integrity Specialist and Cash Transaction analysts, including productivity, quality and account aging.
• Alongside Director, PFS, develop policies and procedures related to Meditech.
• Monitoring all personnel functions of the department, subject to established hospital and departmental personnel policies and in consultation with the Director of Patient Financial Services.
• Maintain a thorough knowledge of payor rules, regulations, policies, and procedures as they impact the billing process.
• Ensure accurate and timely claim submission, payment posting, follow-up, and resolution of outstanding accounts.
• Work with other hospital departments to ensure that the hospital's A/R system is performing as needed.
• Develop and maintain effective professional relationships with representatives of payor organizations in order to facilitate appeals of payor decisions; interpret regulation or policy; gather information pertinent to current or proposed developments.
• Help train, develop, motivate, and assist subordinates in reaching new levels of skills, knowledge, and attitude.
• Promptly identify and communicate payer issues & denial trends, developing measurable action plans for resolution with the Director of Patient Financial Services.
• Monitor staff schedules and adherence to time and attendance protocols.
• Monitor and evaluate revenue cycle performance through KPI, Productivity, & Quality measures.
• Attend meetings, training sessions, and conference calls, as well as team meetings, one-on-one meetings with Director, PFS to provide consistent performance feedback.
• Supervisory responsibilities include but are not limited to interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems with Controller.
• Maintain regular and predictable attendance.
• Perform other essential duties as assigned.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS

• High school diploma or equivalent.
• Must possess a minimum of an Associate’s Degree in Accounting, Business Administration, or Healthcare Administration.
• Minimum of 5 years of Acute & Ambulatory medical billing experience is required.
• Must have previous management experience.
• Meditech experience preferred.
• Must have or obtain CRCR (Certified Revenue Cycle Representative) certification through HFMA within one year of employment.
• Advanced knowledge of UB-04, 1500, EOB interpretation, CPT and ICD 10 codes.
• Intermediate Excel knowledge.
• Understanding of Accounts Receivable KPIs.
• Strong customer service and public contact experience.
• Ability to meet targets and deadlines and maintain emotional balance and self-control so that various situations are conducted confidently and successfully.
• Knowledge of various types of health insurance and other third-party reimbursement, health care billing practices, automated billing and accounting systems, collection laws and techniques on working with debtor’s ability to meet payment obligations.
• Excellent communication skills, both verbal and written.
• Ability to plan, schedule, assign, coordinate, and evaluate the work of subordinates; train staff, read, interpret and apply policies and procedures, analyze data, draw conclusions and make recommendations.
• Must be self-motivated and have the ability to work within the established policies, procedures and practices prescribed by the hospital/clinic.

PHYSICAL/MENTAL REQUIREMENTS

• Must be able to sit and stand, intermittent 8 to 10 hours a day.
• Must be able to use standard office equipment, including the telephone and computer keyboard.
• Continuously works under pressure of near 100% accuracy while meeting inflexible deadlines.
• Continuously utilizes manual/bi-manual dexterity, near vision, speech, and hearing.
• Frequently stands, walks, sits and utilizes eye/hand coordination and color definition.
• Occasionally reaches above shoulder, regularly required to lift and/or carry up to 40 lbs.
• Occasionally walks on uneven surfaces.