What are the responsibilities and job description for the Manager Billing position at Ridgeview Medical Center?
PURPOSE OF JOB
The Manager is responsible for overseeing and optimizing the medical billing and revenue cycle processes to ensure accurate and timely claims submission and compliance with healthcare regulation. This role plays a critical part in maintaining the financial health by reducing claims denials, managing accounts receivables, and sustaining satisfactory staff productivity levels.
JOB FUNCTIONS
1.Provides leadership and oversight of the billing teams. Plans, organizes, assigns, and supervises the activities of staff engaged in the processing of healthcare claims. Provides technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for billing. Ensures appropriate write-off/adjustments and refunds are accurately applied to accounts in accordance with contractual language, accepted accounting practices and regulatory requirements.
2.Recruits, orients, trains, evaluates, and monitors on-the-job performance of department staff. Develops staff to ensure continued professional growth and to provide the competencies the company needs to support its growth and long-term success.
3.Supports the department directorthrough development of programs, goals and objectives consistent with those of the organizations overall strategic plan and initiatives. Manages operating expenses and key indicators within the budget.
4.Complete in-depth management reports including summarization of weekly and monthly A/R performance. Additionally, develop and monitor specific objectives and standards for measurement of staff performance and productivity.
5.Monitors KPI goals. Develop and initiate action plans in response to identified gaps in processes or workflows. Identifies, recommends, and implements changes to comply with department initiatives and department-specific goals. Works with the Director to develop departmental goals, key performance indicators and performance standards.
6.Collaborates with Patient Financial Services and Revenue Cycle Leadership regarding payer edits, contractual changes or other issues impacting the production of clean claims, timely claims submission and accurate payments. Identifies opportunities to reduce claim edits, CFB/DNFB totals, rejections, and payment delays. Participates in the analysis and resolution of complex issues related to billing that could have impact to revenues, including partnering with staff inside and/or outside of the revenue cycle.
7.Collaborates with Patient Accounts Manager in responding to any inquiries regarding account receivables.
8.Interacts with representatives of third-party payors to improve communication, resolve claims processing issues and discuss changes in plan requirements.
9.Responsible to review, maintain, and implement applicable regulatory and department policies and procedures. Ensures compliance with local, state and federal regulatory agency standards.
10. Other duties as assigned.
EMPLOYMENT REQUIREMENTS
- Bachelor's degree in Healthcare Administration, Business Administration or a related field combined with equivalent experience
- Minimum of 4 to 6 years of billing experience
- Minimum 2 to 3 years of leadership and people management
Knowledge/Skills/Abilities
- Professional attitude, excellent leadership and strong interpersonal skills.
- Excellent communication and influencing skills and ability to build strong working relationships at all levels.
- Assures excellent service with a high degree of urgency to internal and external customers.
- Systematic thinking when contemplating and implementing change.
- Strong working knowledge of billing and denial management.
- Must have complete understanding of payor requirements including but not limited to; claim filing guidelines and appeal guidelines.
- Proficiency in Microsoft Suite.
- High level of math proficiency.
- Ability to communicate in the English language for effective written and verbal correspondence to complete job functions as mentioned above.
Preferred Qualifications
- Epic Resolute experience
- Hospital and clinic billing experience
- Demonstrated dispute resolution and strong interpersonal skills
Link to Physical Demands
Compensation
Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.
Benefits
Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families.
Click here to view the benefits available.
Ridgeview Medical Center will not discriminate against or harass any employee or applicant for employment because of race, color, religion, sex, pregnancy, citizenship, national origin, age, disability, military service, veteran status, genetic information, union membership, creed, marital status, familial status, sexual orientation, gender identity, status with regards to public assistance, membership in a local human rights commission, or any other category that may be protected by law.
