Billing Manager

The Billing Manager will be responsible for the supervisory oversight and management of all facets of the billing department to maintain and enhance efficiency and revenue cycle health.

Responsibilities:

• Oversees daily operations, delegates workload, and provides backup coverage to ensure timely and accurate completion of tasks for Eligibility, Medical Billers, and Patient Financial Counselors.
• Demonstrates proficiency in coding and billing hematology, oncology, orthopedic and rheumatology office visits, infusions, hospital charges, orthotics and orthopedic surgery services, radiology, physical therapy, and behavioral health services.
• Performs eligibility verification across all payers including Commercial, Managed Care, and HMO policies. Obtains required authorizations or PCP referrals for office visits.
• Monitors and maintains knowledge on federal, state and payer specific regulations within the specialties offered by the organization.
• Maintains and continuously monitors procedures and workflows to identify root cause for deficiencies, implements workflow improvements, system automations, corrective measures, or education to resolve and uphold billing accuracy while preventing future errors.
• Works in cohort with the Authorization and Referral Manager and the Patient Account Representative – Claims team to identify payer denial trends or billing practices that impact patient balances.
• Facilitates revenue cycle team meetings in concert with the reporting manager and Authorization and Referral Manager to communicate, identify, and address departmental issues.
• Works in concert with the management team to formulate and execute department strategic initiatives.
• Communicates and collaborates regularly with members of the Revenue Cycle team and various internal departments for cross-departmental process improvement initiatives.
• Monitors Charity Care and other assistance programs; ensures programs are offered to patients, families, and caregivers to facilitate timely access to medical care.
• Reviews and discusses 30-60-90 Day Expectations and Training Progress Reviews for new hires along with ongoing competencies for direct reports.
• Creates and maintains documented procedures for assigned billing department tasks and duties to ensure adherence.
• Supports, contributes to, and executes the Senior Director of Revenue Cycle Management’s vision for the team.

Supervisor Responsibilities:

• Directly supervises all employees within the billing department.
• Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees; planning assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Requirements and Skills:

• Bachelor’s degree in healthcare or an Associate with 5 years of healthcare or revenue cycle experience. Master’s in healthcare preferred but not required.
• A minimum of four (4) years of managerial experience.
• Physician office experience.
• Experience in multi-specialty physician setting.
• Certified Professional Coder (CPC), Certified Professional Biller (CPB), Certified Physician Practice Manager (CPPM) or other equivalent certifications preferred but not required.
• Extensive knowledge in CPT and ICD-10 coding, and medical terminology.
• Knowledge in commercial, managed care, HMO and other insurance plan benefits and coverage.
• Ability to creatively integrate competing demands of a multi-specialty setting into a productive working environment.
• Relate quickly and confidentially to patients/parents, physicians, and internal teams.
• Excellent communication skills, using appropriate grammar and professional conversation skills.
• Working knowledge of Microsoft Teams, Word, Excel, and web-based database programs.
• Bilingual (English/Spanish) preferred, but not required.