Billing Manager

Position Summary: The Billing Manager is responsible for managing all day-to-day functions and staff in the Billing Department. The Billing Manager is responsible for oversight of all billing related processes, creating an efficient cadence for completing all tasks timely, managing aging patient accounts receivables, ensuring timely submission of claims, promptly responding to denials, and completing monthly reporting. He/She is expected to have in-depth knowledge of medical billing practices, insurance contracting, provider credentialing and enrollment, and is involved in carrying out all duties related to the billing process. He/She is also responsible for the oversight of the billing staff, assigning duties and tasks, and providing ongoing training and education for the Billing Department staff. This position will report to the CEO/CFO and works closely with all levels of management and staff.

Essential Functions and Responsibilities:

• Develops, implement and oversees effective billing and collection procedures.

• Provides the day-to-day supervision of the Billing Department staff.

• Assist with the management of the configuration of all electronic billing systems and software to ensure proper functioning for effective and efficient billing and collections processes.

• Ensures timely monthly close of the billing function.

• Prepares and distributes end of month management reports.

• Plans and implements quality assurance for all billing processes.

• Develops best practices for the Billing Department functions and workflows.

• Provides chart review and facilitates coding auditing ensure provider coding accuracy.

• Ensures the timely submission of all claims for payment to 3rd party payers.

• Develops, implements and oversees procedures for the review, appeal and resubmission of all claim denials.

• Ensures patient statements are generated and sent promptly and accurately, adhering to the Center’s billing policies.

• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations and provides reports to management or outside entities as appropriate.

• Provide support and training to providers to ensure accurate, timely filing of claims.

• Compiles requested statistical, financial, billing or auditing reports.

• Ensure procedures are in place for the posting of all 3rd parts payments received and reconciliation of expected payments.

• Works with Human Resources (HR) and is responsible for the practitioner credentialing process with all outside entities and 3rd party payers.

• Works in collaboration with Chief Operating Officer (COO) on value-based care and with patient access specialists to optimize collection processes.

• Analyzes claims data and suggest/implement procedures to maximize HEDIS and incentive revenue collections.

• Maintain and manage all applicable registrations and periodic reporting for CMS (Medicare/Medicaid).

• Provides Medicaid and Medicare annual cost reporting support.

• Handle routine correspondence and other administrative tasks as required.

• Assists patients who have billing questions pleasantly and courteously.

• Develops a positive relationship with billing staff.

• Responds appropriately to emergent situations.

• Performs other duties as assigned.

Qualifications:

Required

• High school graduate or equivalent.
• Professional training related to health care coding and billing.
• Must have at least five years of experience in medical billing.
• Must have at least three years of supervisory experience working in a health care or outpatient medical office setting.

Preferred

• Certification in medical billing and coding.

Knowledge, Skills, and Abilities: Required:

Candidate must:

• Knowledge of NextGen EMR preferred.
• Experience in a non-profit medical environment and/or FQHC is highly preferred.
• Must stay current on insurance guidelines, especially Medicare and State of Michigan Medicaid.
• Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Must be organized and have strong attention to detail.
• Excellent communication and interpersonal skills.
• Excellent analytical and problem-solving skills.
• Strong leadership skills with an ability to motivate others.
• Attendance is an essential element of this position.

Job Type: Full-time

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Day shift
• Monday to Friday
• No weekends

Application Question(s):

• Cover letter is required please.

Education:

• High school or equivalent (Required)

Experience:

• medical billing: 5 years (Required)
• supervisory: 3 years (Required)

Work Location: In person