Billing Manager

The Billing Manager is responsible for directing and coordinating the overall functions of the Billing Department to ensure maximization of cash flow while improving patient, provider, and other customer relations. Requires strong managerial, leadership and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.

RESPONSIBILITIES

1. Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.

2. Operates within the guidelines set forth as outlined in the finance policy manual.

3. Liaison between Billing, Practice Managers, Nursing Manager and Administrative Team for disseminating information between all parties.

4. Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.

5. Analyze billing and claims for accuracy and completeness; Oversee Claim Submission to proper insurance entities and follow up on any issues.

6. Maintains contact with other departments to obtain and analyze additional patient information to document and process billings.

7. Prepared and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts in concert with the Practice Administrator. Collects and compiles accurate statistical reports.

8. Audits current procedures to monitor and improve efficiency of billing and collections operations in conjunction with the Chief Financial Officer, Chief Executive Officer and Billing Director.

9. Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.

10. Participates in the development and implementation of operating policies and protocols.

11. Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.

12. Analyzes trends impacting charges, coding, collections and accounts receivable to take appropriate action to realign staff and revise policies and procedures.

13. Ensures coding is accurate and providers receive regular training in conjunction with Billing Director.

14. Keep up to date with carrier rule changes and distribute the information within the practice.

15. Responsible for all physician credentialing actions in conjunction with Billing Director.

16. Understands and remains updated with current coding and billing regulations and compliance requirements.

17. Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.

18. Maintains library of information/tools related to documentation guidelines and coding.

19. Supervises billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance; provides oversight for new and existing billing staff on applicable operating policies, protocols, systems and procedures.

20. Coordinates team member time off in a manner that does not negatively impact necessary daily functions.

21. Participates in the Care Team as outlined in KVHC protocols.

22. Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.

23. Maintains up to date systems and implements changes as third party insurance changes occur.

24. Maintains systems of checks and balances of encounters to verify maximization of charges.

25. Maintains systems of checks and balances of EOB’s to verify maximization of revenue.

26. Completes chart/coding audits annually

27. Performs additional duties or projects as assigned by the Billing Director.

28. Adheres to all KVHC policies and protocols.

29. Complies with all safety rules and protocols. Reports all incidents, regardless of severity, immediately to their supervisor and completes an incident report and investigation form, which will be forwarded to Human Resources within 24 hours of the incident.

30. Conducts themselves as a good steward in the communities served by KVHC; represents the organization at outreach activities as needed.

31. Actively participates as committee member as assigned by the Chief Executive Officer.

32. Interacts harmoniously and effectively with others. Focusing on the attainment of organization goals and objectives through a commitment to teamwork.

33. Conforms to acceptable attendance and punctuality standards as expressed in the employee handbook.

34. Abides by the organization’s compliance program and requirements.

35. At times you may be faced with challenges that may impact patient care. Addressing these challenges may not be in your job description, however Katahdin Valley Health Center encourages each team member to go above and beyond to address the patients’ needs in the moment. Employees have the autonomy to see the care experience through from A to Z to show our patients KVHC C.A.R.E.S.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Education:

• Associate (Required)

Work Location: In person