In-House Billing Manager

Description

POSITION PURPOSE:

The In-House Billing Manager serves to help increase revenue through analysis of billing codes and services and reimbursement. This person will serve as a key thought partner for the executive team and analytics leader throughout the company. They will assist and manage the daily billing and reporting as a component of the Revenue Cycle Management team.

Qualifications

POSITION REQUIREMENTS/QUALIFICATIONS

EDUCATION:

Preferred Graduate from an accredited college or university with a minimum of Bachelors’ Degree in various disciplines. Experience may be substituted for degree. Minimum of High School Diploma and/or GED

EXPERIENCE:

Minimum of three (3) years billing experience in substance use or mental health or at a community health center, outpatient department of a hospital, or physician group practice.

LICENSURE/CERTIFICATION:

None

KNOWLEDGE AND TRAINING  REQUIRED AT TIME OF HIRE:

• Knowledge of the Principles and Practices of the discipline of account billing and collections
• Experience in CPT and ICD-9 coding; familiarity with medical terminology.
• Adheres to the facility ethics code. 
• Knowledge of Joint Commission Standards.
• Demonstrates Proficiency in Communication & Written skills.
• Knowledge of State & Federal Statutes Regarding Client Confidentiality laws.
• Knowledge of Drug-Free Workplace Policies.
• Knowledge of Workplace Violence.

AGE SPECIFIC INDIVIDUALS SERVED/ RESPONSIBILITY:

Adults

SPECIFIC AREAS OF RESPONSIBILITY TO POSITION

1. Maximize collections on assigned program service billing including institutional, and professional services. Ensure accurate and timely filing, follow up of all claims. Keep the Supervisor of Billing and/or Manager of Billing Operations apprised of all outstanding claims issues or concerns.
2. Work closely with the CFO, collections department, and all facility locations with obtaining and maintaining accurate charge capture, coding/ diagnosis, insurance, and financial information in billing system.
3. Identify, research, and resolve all services that are in a suspended status within the patient accounting system and ensures submission of claims to correct payor.
4. Follow up on all outstanding unbilled claims as outlined in the Accounts Receivable process and procedures, providing a detailed account on all claims in an outstanding status.
5. Research and resolve all claim master rejections. Rebill and/ Resubmission for corrective and replacement claims to insurances that has not paid or has been denied unjustly.
6. Perform other duties as necessary to facilitate the goals and objectives of the Company.
7. Works extremely well under pressure, meet multiple and often competing deadlines.
8. Ensure timely processing of claims, denial re-submittal, and accounts receivable management to meet compliance measures.
9. Responsible for accurate and timely preparation and submission of claim to third party commercial carriers and intermediaries according to facility, state, federal and payer guidelines.
10. Responsible for other job-related duties as assigned by the CFO.
11. Responsible to gather and review data for billing and ensure that data is correct prior to entering into system.
12. Responsible to accurately post insurance and other receipts to clients account ensuring that receipts are posted correctly and balanced daily.
13. Essential duties include the ability to gather, review, and enter data accurately, must be detail oriented, have good communication skills and good organizational skills.
14. Complies with facility policies and procedures.
15. Maintains confidentiality of client information and records; and of facility proprietary, privileged, and/or confidential information.
16. Completes daily tasks as assigned and documents the delivery of all client services.
17. Attends in-services and educational training as necessary and as assigned.
18. Seeks out learning experiences and incorporates new knowledge into practice.
19. Protect the privacy of all client information in accordance with GRNH, LLC’s privacy policies, procedures and practices, as required by federal and state law, and in accordance with general principle of professionalism as a health care provider.  Failure to comply with GRNH, LLC’s policies and procedures on client privacy may result in disciplinary action up to and including termination of employment.
20. May access protected health information (PHI) and other patent information only to the extent that is necessary to complete your job duties.  The incumbent may only share such information with those who have a need to know specific client information you have in your possession to complete their job responsibilities related to treatment, payment or other GRNH, LLC operations.
21. Expected to report, without the threat of retaliation, any concerns regarding GRNH, LLC’s policies and procedures on client privacy and any observed practices in violation of the policy to their supervisor.
22. Performs other duties assigned.

Salary : $65,000 - $80,000