Billing Manager

Billing Manager

The Billing Manager is responsible for overseeing the claims department and ensuring that all claims are handled in a timely, accurate, and cost-effective manner. This role involves reviewing complex claims, improving claims processing workflows, and maintaining compliance with legal and regulatory standards. The Billing Manager also ensures customer satisfaction through effective communication and dispute resolution.

Key Responsibilities:

1. Claims Process Management:

· Oversee the end-to-end claims process, from initial claim filing to settlement.

· Develop and implement procedures to improve efficiency and accuracy in claims handling.

· Ensure compliance with internal policies, legal requirements, and industry regulations.

· Investigate complex claims, including reviewing documentation, and collaborating with legal and medical professionals when necessary.

· Manages front end and back end of the billing operations.

2. Team Leadership, Development and Management:

· Oversees the Billing Department by setting performance goals, monitor employee performance, and provide feedback.

· Works with Partners and Clinic Directors to monitor progress on billing claims.

· Coordinates with Regional Office Manager on front desk operations

· Conduct regular training sessions to keep the team up to date with industry best practices and new regulations.

· Oversees department’s daily activities and tasks, policies and procedures, staffing & resources (levels & effectiveness) and reporting requirements.

3. Claims Review and Resolution:

· Review claim documentation and assessments to ensure accurate and fair settlements.

· Collaborate with legal, medical, and other professionals to resolve disputes and facilitate settlements.

4. Data Analysis and Reporting:

· Analyze claims data to identify trends, risks, and areas for improvement.

· Generate reports on claims performance, department productivity, and costs for senior management.

· Use data insights to recommend process improvements and cost-reduction strategies.

5. Additional Responsibilities:

· Works on special projects as determined by business needs and requires strong independent work ethic.

· Reviews and researches accounts to identify errors with claims, takes the required actions including following up with the pertinent personnel to obtain the required information to address and resolve the identified issues.

• Serve as the escalation point for complex billing issues, patient account concerns, or payer disputes.

· Ensures corrected claims are created and sent to the payer in a timely fashion.

· Reviews account information and able to explain charges and other related inquiries related to the special project while complying with HIPAA guidelines.

· Document all actions in all systems according to policy.

· Maintain courteous and cooperative working relationships with all levels of management, employees, patients and guarantors.

· Oversees data within EMR System.

· Endures billing success to insurances and patient billing success.

· Perform other duties as assigned.

Qualifications:

· 3 years or more of medical billing/collections experience

· Management and supervisory experience

· Experience in data management working with spreadsheets and PC literate

· Well organized and detail oriented; ability to effectively manage multiple tasks and deadlines

· Working knowledge of ERA/EDI for claim payment posting and remittance processing

· Effective and comfortable communicator

· Flexible and positive attitude and high level of comfort in a dynamic and changing environment

· Working knowledge of ICD-10, CPT, and HCPCS coding systems.

· Strong sense of job ownership

· Ability to take initiative and work well with minimal supervision

· Good problem-solver and trouble-shooter

· Experience with business correspondence.

· Excellent communication skills are necessary to accomplish job duties.

Job Type: Full-time

Pay: $40,000.00 - $50,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Paid time off
• Parental leave
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• Overtime

People with a criminal record are encouraged to apply

Work Location: In person

Salary : $40,000 - $50,000