What are the responsibilities and job description for the Billing Manager position at Agape Family Health?
Department:
Finance
Job Title:
Billing Manager
Reporting to:
CFO
FLSA Status:
Exempt
Date Prepared:
September 2022
Job Summary:
The Billing Manager will be responsible for overseeing charge entry and coding. Support increasing business profitability by ensuring accurate coding, analyzing and resolving denials, rejections/initiate best practices, and reduce days in accounts receivable.
Essential Duties and Responsibilities:
- Oversee the outsourced Cash Application Department to ensure timely payment posting, credit resolution, reconciliation of payments received and resolving unposted cash.
- Manages the Site Billing and Coding to maximize efficiencies with charge entry, claim rejections, denials, claim processing, and coding.
- Review billing denial queues on a daily basis to ensure the timely resolution of denials.
- Responsible for accurate and timely application of transactions including adjustments and write-offs.
- Monitor all aspects of billing activity and initiate appropriate corrective measures as needed. Communicates performance data and associated actions plans to Senior Leadership.
- Resolve complex patient, physician and other issues when necessary.
- Monitor and resolve issues identified by the Clearing House.
- Communicate with payers and know when and how to escalate payer issues.
- Oversee the hiring, training and supervision of the billing specialist that generates and submits claims.
- Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains a working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
- Familiarity with third party reimbursement methodologies. Communicates with A/R team and Senior Leadership on changes in managed care reimbursement and expectation of changes in insurance guidelines.
- Keeps abreast of compliance regulations, standards and directives regarding governmental/regulatory agencies and/or third-party payers. Ensure communication and education of such to the billing department and management.
- Must be able to meet deadlines given by Senior Leadership.
- Works with sensitive and confidential materials and must be able to exercise discretion.
- Other duties as assigned
The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.
Education and Experience Requirements:
- A high school diploma or equivalent is required.
- A bachelor's degree is preferred.
- Minimum of five years’ experience within a billing department in healthcare revenue cycle operations, coding, and medical terminology.
- Prefer experience working with multiple physician specialties.
- Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude.
- Demonstrated experience resolving denied claims.
Knowledge/Skills/Abilities:
- Knowledge of claims processing and editing systems.
- Strong knowledge of Medicare and Medicaid payer guidelines.
- Knowledge of CPT, HCPCS and diagnosis coding.
- Skilled in effective data collection and analysis.
- Interpersonal skills essential to communicate effectively, written and oral, with internal and external personnel at various levels.
- Skill in effectively managing multiple projects simultaneously.
- Ability to multitask and work well under pressure.
- Ability to analyze problems and interpret information and to prioritize and reprioritize, as necessary.
- Ability to work independently, and as part of a team.
- Ability to read and interpret payer contracts.
