Billing Manager (FT - Days)

Description

The Billing Manager will be responsible for overseeing and managing the day-to-day operations of the hospital's billing team, ensuring accurate and timely submission of claims, as well as compliance with hospital policies, government regulations, and payer requirements. The Billing Manager will report directly to the Director of Revenue Cycle and collaborate closely with other departments, including finance, coding, patient access, and insurance verification, to ensure the effective operation of the hospital's revenue cycle processes. The Billing Manager position plays a crucial role in maintaining the hospital's financial health and sustainability.

Billing Manager Responsibilities :

• Supervise, mentor, and evaluate the performance of the billing team, ensuring staff is properly trained and motivated to meet department goals.
• Works closely with the Revenue Cycle Director to establish sound benchmarks and measurable goals to meet national standards.
• Oversee the preparation, review, and submission of all patient and insurance claims in a timely and accurate manner.
• Ensure compliance with billing regulations, including Medicare, Medicaid, and commercial payer guidelines.
• Monitor billing processes to reduce errors, denials, and rework; implement corrective actions as needed to improve efficiency and accuracy.
• Collaborate closely with the Director of Revenue Cycle to develop and refine billing policies, workflows, and procedures.
• Coordinate with external billing agencies, early-out and collection vendors, if applicable, to ensure proper billing practices and timely collections are established and sustainable.
• Serve as the primary point of contact for escalated billing issues, denials, and payer inquiries.
• Communicate regularly with Revenue Cycle Director to report status and teams state of progress to include, but not limited to, updates on A / R, DNFB, and Collections.
• Assist the Director of Revenue Cycle in review and upkeep of chargemaster.
• Provide guidance, training, and support to the billing team to improve overall billing practices and performance.
• Develop and implement regular team meetings and training sessions to keep staff informed of updates to billing practices, payer requirements, and new regulations.
• Establish performance standards, conduct performance reviews, and provide constructive feedback to team members.
• Foster a collaborative, supportive environment to promote employee engagement and satisfaction.
• Generate and analyze daily, weekly, and monthly billing reports to track claim submission, denial rates, aging accounts, and overall collection results.
• Identify trends in claim denials or delays, and work with appropriate teams (coding, insurance verification, etc.) to address and resolve root causes.
• Report billing activities and issues to the Director of Revenue Cycle and provide recommendations for process improvements.
• Assist with the preparation of periodic financial reports related to the hospital's revenue cycle, including aged accounts receivable (A / R) and revenue collection projections.
• Ensure all billing activities are in compliance with healthcare laws and regulations, including HIPAA, the Affordable Care Act, and payer-specific requirements.
• Work with Corporate Compliance to conduct internal audits to ensure billing practices are consistent with hospital policies and regulatory standards.
• Assist with the implementation of audits and respond to external audits or payer inquiries, as necessary.
• Collaborate with coding, finance, and patient access teams to ensure clean claim submission, accurate coding, and timely resolution of billing-related issues.
• Communicate with insurance companies, patients, and third-party vendors to resolve billing discrepancies and payment issues.
• Support the Director of Revenue Cycle in preparing for payer audits, government regulations, and other external reviews.

Billing Manger Requirements :