Manager Billing

PURPOSE OF JOB
The Manager is responsible for overseeing and optimizing the medical billing and revenue cycle processes to ensure accurate and timely claims submission and compliance with healthcare regulation. This role plays a critical part in maintaining the financial health by reducing claims denials, managing accounts receivables, and sustaining satisfactory staff productivity levels.

JOB FUNCTIONS

1.Provides leadership and oversight of the billing teams. Plans, organizes, assigns, and supervises the activities of staff engaged in the processing of healthcare claims. Provides technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for billing. Ensures appropriate write-off/adjustments and refunds are accurately applied to accounts in accordance with contractual language, accepted accounting practices and regulatory requirements.

2.Recruits, orients, trains, evaluates, and monitors on-the-job performance of department staff. Develops staff to ensure continued professional growth and to provide the competencies the company needs to support its growth and long-term success.

3.Supports the department directorthrough development of programs, goals and objectives consistent with those of the organizations overall strategic plan and initiatives. Manages operating expenses and key indicators within the budget.

4.Complete in-depth management reports including summarization of weekly and monthly A/R performance. Additionally, develop and monitor specific objectives and standards for measurement of staff performance and productivity.

5.Monitors KPI goals. Develop and initiate action plans in response to identified gaps in processes or workflows. Identifies, recommends, and implements changes to comply with department initiatives and department-specific goals. Works with the Director to develop departmental goals, key performance indicators and performance standards.

6.Collaborates with Patient Financial Services and Revenue Cycle Leadership regarding payer edits, contractual changes or other issues impacting the production of clean claims, timely claims submission and accurate payments. Identifies opportunities to reduce claim edits, CFB/DNFB totals, rejections, and payment delays. Participates in the analysis and resolution of complex issues related to billing that could have impact to revenues, including partnering with staff inside and/or outside of the revenue cycle.

7.Collaborates with Patient Accounts Manager in responding to any inquiries regarding account receivables.

8.Interacts with representatives of third-party payors to improve communication, resolve claims processing issues and discuss changes in plan requirements.

9.Responsible to review, maintain, and implement applicable regulatory and department policies and procedures. Ensures compliance with local, state and federal regulatory agency standards.

10. Other duties as assigned.

EMPLOYMENT REQUIREMENTS