What are the responsibilities and job description for the Medical Billing Manager position at Bucksport Regional Health Center?
At BRHC we are compassionate about our work and continually strive for excellence in every program we offer. We are committed to treating each patient and employee with respect and dignity. Our goal is to be our patient’s partner in wellness and as such, we provide our patients with individualized education on prevention and treatments to meet specific health care needs. Become a member of our valuable team and join us in the rewards of working in our community health center.
The Medical Billing Manager provides supervisory oversight and management of all facets of the billing department including claims processing, revenue monitoring and quality improvement initiatives. Works cooperatively with other managers and administration to ensure timely billing, reporting and patient account management according to Health Center practices and procedures
Requirements:ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Performs overall revenue management including: satisfying timely filing requirements and maximizing billing revenue and collections, and resolution of unpaid claims.
2. Billing department electronic medical record (EMR) super user and co-administrator with CAS (Clinical Application Specialist) support and training.
3. Responsible for all aspects of the Medical Billing team members and responsibilities.
4. Manages claims processing cycle with the Clearinghouse. Monitors claims submission through Clearinghouse.
5. Monitors reports to ensure clean claims submissions.
6. Monitors monthly aging reports and conduct follow-up on unpaid claims and take appropriate action to correct and re-bill for reimbursement.
7. Monitors open encounters as it relates to claims.
8. Identifies, researches and resolves system issues through indirect or direct contact with payors, clearinghouses and software vendors. Works closely with CAS in problem resolution.
9. Provides technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for FQHC billing.
10. Develops, implements, and maintains BRHC revenue cycle standard operating procedures (SOPs).
11. Researches and maintains billing compliance and regulations, primarily for FQHC Medicare and Medicaid.
12. Performs regular audits of staff to identify coding and billing errors and educate them on errors. Work with billing team and other BRHC staff to address; notify on-site management of problems and troubleshoot as needed.
13. Monitors A/R aging and payment reports monthly to identify trends and underpayments; investigate causes and take appropriate steps toward resolution using professional judgment.
14. Performs month end close and provides monthly updates of revenue cycle status including reports, metrics, and presentations. Works with CFO and Staff Accountant as needed to accomplish.
15. Provides training as required to on-site staff regarding billing and other revenue cycle related tasks, standard operating procedures (SOPs).
16. With other members of the management team, develop continuous process and priorities for quality improvement to improve revenue cycle outcomes.
17. Handle and be knowledgeable of all software utilized in the management of operations related revenue for BRHC, including understanding of pertinent service contracts.
18. Maintain professional and technical knowledge by attending educational workshops, and other activities such as: reviewing professional publications; establishing personal networks; participating in professional societies such as the Maine Primary Care Association (MPCA).
19. Manage relationships with outside contractors such as coding, billing vendors, credentialing and other revenue related services.
20. Performs the usual duties of a manager, including hiring, scheduling, supervising, delegating, training, developing and evaluating subordinate staff, resolves human resource issues, maximizes employee performance and morale; keeps staff informed on goals, expectations and issues
21. Performs special projects and other duties as requested.
NON-ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. May provide backup for other Health Center functions as needed.
2. Performs other duties as assigned.
GENERAL EXPECTATIONS:
1. Be committed to the mission of the Bucksport Regional Health Center.
2. Work as a member of the Finance team in the performance of duties.
3. Be punctual for scheduled work and use time appropriately.
4. Work in harmonious relationships with all staff, patients, vendors and others.
5. Perform duties in a conscientious, cooperative manner.
6. Perform the required amount of work in a timely fashion with a minimum of errors.
7. Be neat and maintain a professional appearance.
8. Maintain confidentiality and protect the Center by keeping information concerning Operations, patients and employees confidential.
9. Participation in community activities as a representative of Bucksport Regional Health Center.
PHYSICAL REQUIREMENTS:
The physical requirements described here are representative of those that must be met by the Incumbent to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to stand; walk; sit; use hands to handle, or feel, including operation of a standard computer keyboard; reach with hands and arms and talk, see and hear; prolonged sitting required. Eye hand coordination and manual dexterity is required. The employee must occasionally lift/move up to 25 pounds, bend, stoop, stretch or crouch. Specific vision abilities required by the job include close vision, distance vision, and the ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those of the incumbent encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Work is performed primarily in an office setting. Noise levels are usually quiet.
QUALIFICATIONS NEEDED FOR POSITION:
Education Requirements:
- A bachelor’s degree from an accredited college or university in a business or related field, or equivalent relevant experience with progressive development of responsibilities.
Experience and Skill Requirements: The following experience and skills are considered essential:
- At least five years of Business Office Management experience; prefer some experience as a department manager.
- Proficiency in use of billing software applications and general Microsoft Office applications required.
- Experience working with all types of third-party payers. (HMO, PPO, Medicare/Medicaid, etc.) and understanding of FQHC billing requirements
- Excellent communication and organizational skills
- Demonstrates accountability, integrity, professionalism, openness, receptive to change creativity and innovative.
- Ability to establish and maintain effective working relationships with other employees and the public.
- Ability to communicate and present information.
- Ability to read, interpret, and apply clinic policies and procedures.
- Ability to identify problems and recommend solutions.
- Ability to establish priorities and coordinate work activities.
** All requirements and skills are considered to be essential, unless otherwise indicated. **
