Medical Biller

Job Summary:The Medical Biller Manager oversees the medical billing process in a healthcare setting, ensuring that claims are accurately processed and timely submitted to insurance companies, and that payments are collected efficiently. This role involves managing a team, resolving billing issues, and ensuring compliance with all billing and coding regulations.Responsibilities:Leadership and Staff Management:

• Supervise Medical Billing Team: Lead and manage a team of medical billers, assigning tasks, overseeing daily activities, and ensuring optimal performance.
• Training and Development: Provide training and ongoing support to the billing team, ensuring they are knowledgeable about medical billing procedures, software, and compliance requirements.
• Performance Management: Set performance goals for the team and evaluate their work to ensure that billing is accurate, timely, and in compliance with industry standards.
• Problem Resolution: Resolve complex billing issues escalated by the billing team or patients, including claim rejections, denials, or payment discrepancies.

Medical Billing Oversight:

• Claims Submission: Oversee the timely and accurate submission of claims to insurance companies, ensuring all required documentation and coding are included.
• Insurance Verification: Ensure that patient insurance information is correctly verified and updated before claims are submitted.
• Coding Accuracy: Ensure that all medical codes (CPT, ICD-10, HCPCS) are accurate and reflect the services provided by healthcare providers.
• Charge Entry: Oversee the accurate entry of charges into the billing system, ensuring that all patient services are accounted for.
• Payment Posting: Ensure accurate posting of payments and adjustments to patient accounts.

Compliance and Regulations:

• Compliance with Laws and Policies: Ensure that all billing practices comply with federal, state, and local regulations, including HIPAA, and insurance requirements.
• Audit and Documentation: Conduct periodic audits of billing records to ensure accuracy and compliance. Ensure that documentation supports all charges and that proper authorizations are in place.
• Insurance Contracts and Negotiations: Collaborate with healthcare providers and insurance companies to negotiate rates and ensure compliance with insurance contracts.

Financial Reporting:

• Generate Billing Reports: Create and present reports to management, detailing billing performance, denials, accounts receivable (AR), and revenue cycle metrics.
• Accounts Receivable Management: Track and manage AR aging reports, ensuring overdue accounts are followed up on and resolved promptly.
• Monthly and Quarterly Reports: Produce and analyze financial reports, including total claims submitted, claims paid, claims denied, and outstanding balances.
• Cash Flow Monitoring: Monitor and report on the practice's cash flow, ensuring that payments are collected promptly and any issues with delayed payments are addressed.

Patient Billing and Collections:

• Patient Inquiries: Address patient billing inquiries, explaining charges, insurance coverage, and payment options.
• Collections: Oversee the collection of outstanding patient balances, managing payment plans or offering financial assistance when necessary.
• Statement Generation: Ensure accurate generation of patient statements, detailing services provided, insurance payments, and patient responsibility.

Key Tasks:

• Monitor Insurance Payment Trends: Keep track of changes in insurance policies, billing requirements, and reimbursement trends to adjust billing processes accordingly.
• Manage Denials: Review and analyze claim denials to identify trends or errors in coding or documentation, and take corrective actions as needed.
• Billing Cycle Management: Manage the entire billing cycle, from charge entry to claim submission, payment posting, and collections.
• Team Collaboration: Work closely with clinical and administrative staff to ensure that billing is accurately linked to services rendered.
• Patient Financial Counseling: Provide financial counseling to patients, explaining their coverage, balance due, and payment options.

Reports and Documentation:

• Daily/Weekly Billing Reports: Track and report daily and weekly billing activities, including claims submitted, claims paid, and claims denied.
• Accounts Receivable (AR) Aging Report: Review and manage AR aging reports to ensure that accounts are followed up on regularly and collections are pursued as needed.
• Denial Reports: Analyze denial trends and track the resolution status of denied claims.
• Monthly Revenue Cycle Reports: Report on the revenue cycle, including the volume of claims, reimbursement rates, outstanding balances, and collections.
• Cash Flow and Payment Reports: Provide monthly reports on the practice's cash flow, including insurance payments, patient payments, and outstanding balances.

Steps Involved in the Billing Process:

• Patient Registration and Insurance Verification: Ensure that patients’ insurance information is collected, verified, and entered accurately into the system.
• Charge Capture: Verify that all services provided to the patient are properly documented and entered into the system with the correct coding.
• Claims Submission: Prepare and submit claims to insurance companies, ensuring accuracy in coding and documentation.
• Follow-up and Appeals: Track claims, follow up on unpaid or underpaid claims, and file appeals for denied claims.
• Payment Posting: Once payments are received, post them to the appropriate accounts and reconcile any discrepancies.
• Patient Billing: Send statements to patients for any remaining balance after insurance payments and assist with payment plans or collections as necessary.
• Reporting and Analysis: Generate reports on the billing process, AR, and other key performance indicators to assess the financial health of the practice.

The Medical Biller Manager is a pivotal role in ensuring the financial health of the practice by overseeing billing processes, ensuring compliance, managing AR, and working closely with insurance companies and patients. Their leadership helps ensure that the practice receives timely reimbursements and maintains strong cash flow.

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Ability to Commute:

• Mesquite, TX 75149 (Required)

Ability to Relocate:

• Mesquite, TX 75149: Relocate before starting work (Required)

Work Location: In person

Salary : $18 - $25