Billing and Coding / Practice Manager

OB/GYN PROFESSIONALS OF EAST TENNESSEE

JOB DESCRIPTION

OFFICE MANAGER

SUMMARY

Directs and coordinates activities of the organization in accordance with identified goals and as directed by physicians to obtain optimum efficiency, economy of operations, and maximize profits by performing the following duties. Adheres to strictest guidelines with regards to patient privacy.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1)                Plan, develop and implement organizational policies and goals to facilitate            peak productivity and profitability.

2)                Maintains accounts payable in current standing. Analyzes supply costs to identify areas in which reductions can be made.

3)                Initiates and maintains contracts with vendors and other companies with   which the corporation has a business relationship. 

4)                Reviews operations and expenditures with physicians on monthly basis to determine possible changes that may be required.

5)                Responsible for informing staff of new policies and procedures and for     directing the implementation of same.

6)                Maintains personnel files, prepares payroll, administers and tracks employee benefits. Completes Federal and State tax forms as required.  Works with CPA to correlate necessary information for annual reports and    filings. Prepares W-2s and 1099s annually.

7)                Manages employees of corporation, maintaining clear communication       with regards to performance, expectations, productivity and accountability.

8)                Maintains over-view of Accounts Receivable. Prepares reports as directed           by physicians.

9)                Maintains insurance contracts, fee schedules, protocol changes and            credentialing as needed. 

10)            Maintains physician and office licensures and memberships as required.

11)            Manages all bank accounts by depositing and recording all monies collected, collecting payment on returned checks and performing reconciliations.                       

12)            Prepares and sends patient appointment recalls.

13)            Maintains all Centricity and Impact databases. Configures and maintains  office schedule in Centricity.

14)            Maintains all PCs, printers, servers and other office equipment.      Troubleshooting, performing routine maintenance, performing repairs            and/or obtaining outside service as needed.

15)            Schedules all surgery cases. Compiles insurance coverage and benefit      information in order to calculate patient responsibility. Secures pre-       payment from patient. Secures pre-certification. Secures and delivers              physician orders.

16)            Verifies insurance coverage and/or precertification needs for IUDs.

17)            Ensures records and orders are completed and delivered to L&D prior to               deliveries.

18)            Maintains adequate clerical supplies and equipment purchases as needed.

19)            Double checks encounter forms to make sure all appointments, testing, etc            is completed. 

20)            Ensures timely compliance with ICD9 and CPT guidelines, including                    Centricity and encounter form updates and employee/physician training.

21)            Posts charges for all surgeries and deliveries.  Splits global charges

                 resulting from insurance changes during pregnancies.   Obtains billing                        information and files claims for all circumcisions. Reviews all surgery     

                 and delivery reports to insure billing has been accomplished accurately.

22)            Prepares and reviews monthly patient account statements. Refers past-due           accounts to physicians according to Collections Protocols.

23)            Prepares and forwards patient accounts to Transworld and/or Collection    Agency as directed by physicians.

21)            Audits accounts and prepares refunds to patients and insurance companies                        as needed.

22)            Responds to insurance companies’ requests for pre-existing review and                             other records.

23)           Reviews and analyzes problem EOBs referred by A/R Assistant and                           prepares response or corrective action as needed.

24)            Processes electronic claims and resulting reports

26)            Serves as corporation Compliance Officer, Privacy Officer and OSHA                       Officer.

27)            Ensures adequate organization and cleaning of office is accomplished.

28)            Cross trains to cover Check-in, Check-out and A/R Assistant positions as                   needed.

29)            Attends hospital and insurance company sponsored informational                               meetings, and other meetings as needed.

30)            Organizes and facilitates any new projects as directed by the physicians.

QUALIFICATIONS

High school diploma required. Previous medical office experience and supervisory experience required. A/R and A/P proficiency required. Medical terminology and medical coding experience required. Must be computer literate and proficient in various software programs. Must have basic understanding of computer hardware and other office machinery. Must be able to communicate with patients, physicians, other facilities and all visitors in efficient, courteous and professional manner.

Must be able to prioritize multiple responsibilities.

REPORTING 

Position is under the direct supervision of the practice physicians.