BUSINESS OFFICE MANAGER

Medical Billing Manager

This position is responsible for overseeing the billing coding staff and making day-to-day decisions; responsible for understanding and coding all procedures within regulatory mandates; assists with following up on insurance claims and submit appeals as needed. This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. The Medical Billing Manager position requires the ability to produce and present detailed billing activity reports

Duties and Responsibilities: All other duties as assigned

• Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, pre-authorization, referrals and reimbursement management
• Serves as the go to person for all coding and billing processes
• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection
• Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
• Follow up on claims using various systems
• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
• Prepares and analyzes accounts receivable reports, and weekly and monthly financial reports in concert with the Executive Director
• Collects and compiles accurate statistical reports
• Audits current procedures to monitor and improve efficiency of billing and collections operations
• 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
• Participates in the development and implementation of operating policies and procedures
• Reviews and interprets operational data to assess need for procedural revisions and enhancements
• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures
• Keep up to date with carrier rule changes and distribute the information within the department
• Understands and remains updated with current coding and billing regulations and compliance requirements
• Supervises billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
• Provides, oversees, and/or coordinates the provision of training for new and existing billing staff on policies, procedures, etc.

Requirements:

• Minimum of three (3 ) years of medical insurance/healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations required
• Two years (2 ) supervisory or management experience preferred
• A combination of education and experience will be considered