What are the responsibilities and job description for the Billing Manager position at Tri-Cities Community Health?
Description
The Billing Manager is responsible for managing the revenue cycle to include billing and coding staff and is responsible for accurate and timely billing, data entry, insurance contract compliance, charge corrections, payment entry, adjustments, denial corrections, and other activities performed by the department. This position works across the organization to create efficient workflows in the revenue cycle and ensures that the billing and related functions of the practice management system are operating effectively.
Essential Functions
1. Establishes and implements controls to ensure appropriate submission, billing and payment cycles.
2. Analyzes data from practice management systems, insurance companies and governmental agencies, disseminates information to staff, and prepares reports.
3. Keeps abreast of all payors’ reimbursement requirements and implements changes.
4. Develops and provides training for the department and other groups across the organization.
5. Manages all end-of-month processes in relation to encounter charges, adjustments, credit balances and payments. Reviews and verify all reports for data accuracy.
6. Assists in establishing departmental policies, procedures, and coding practices. Incorporates new medical and surgical practices as well as new codes into coding policies in a timely manner.
7. Performs periodic reviews of records coded by coding staff to evaluate the quality of the department’s coding. Conducts follow-up reviews within the designated timeframe to monitor improvement in the problem areas identified.
8. Leads audits of patient records and provides feedback to appropriate staff on areas of improvement, as needed.
9. Attains all agreed to goals and objectives within specified time frames, as part of the organization’s overall mission.
10. Ensures collections of receivables from government entities, private insurance, and patients are timely and accurately applied.
11. Develops monthly statistical reporting for tracking success of the department.
12. The duties herein describe the principal functions of this job, level of knowledge and skills, typically required, scope of responsibility, work requirements, and working conditions, but are not all inclusive. Individuals may perform other duties and TCCH reserves the right to modify, add, or remove duties and assign other duties as necessary, including work in other functional areas to cover absences or relief, to equalize work periods, or otherwise balance the workload.workload.
Requirements
Minimum Education: Bachelor’s Degree preferred
Minimum Work Experience: Experience with a practice management system (NextGen, Epic, etc.) required. 5 Years’ experience in the related field with 1-3 years of supervisory experience in a union environment preferred.
Required Licenses/Certifications: None
Required Skills, Knowledge, and Abilities:
Proficient knowledge of Medicare, Medicaid and third-party billing rules and regulations.
Exceptional written and verbal communication skills.
Analytical thinking skills and the ability to exercise sound judgment when making decisions.
Must be customer service oriented and prepared to liaise with patients, families and other care providers.
Extremely organized and detail oriented.
Knowledge of ICD-10, CPT, HCPCs coding as well as CMS 1500 and UB-04 requirements.
Proficient skills in Microsoft Office suite and the ability to develop proficiency in enterprise software.
Ability to recruit, train and lead a team.
Tri-Cities Community Health is an Equal Opportunity Employer and considers qualified applicants for employment without regard to race, color, creed, religion, national origin, sex, sexual orientation, gender identity and expression, age, disability, veteran status or any other protected factor under federal, state or local law
Salary : $71,250 - $96,188
