What are the responsibilities and job description for the Manager of Billing position at True Health?
Job Summary
The Manager of Billing manages a variety of complex administrative, and billing procedures. Ensures staff’s review and submission of claims, assignment of specified billing codes to medical diagnoses and/or clinical procedures. Ensures that medical billing conforms to all legal and procedural mandates. Stays apprised of Center for Medicare and Medicaid Services, (CMS) standards and Healthcare Common Procedure Coding System, (HCPCS) revisions. Responsible for assisting assigned manager with payer contracts.
Primary Functions
The Manager of Billing manages a variety of complex administrative, and billing procedures. Ensures staff’s review and submission of claims, assignment of specified billing codes to medical diagnoses and/or clinical procedures. Ensures that medical billing conforms to all legal and procedural mandates. Stays apprised of Center for Medicare and Medicaid Services, (CMS) standards and Healthcare Common Procedure Coding System, (HCPCS) revisions. Responsible for assisting assigned manager with payer contracts.
Primary Functions
- Ensures due diligence in the research, analysis, and interpretation of patient medical records to identify and determine amount and nature of billable services, assignment and sequencing of appropriate diagnostic/procedure billing codes for the purpose of reimbursement, in compliance with requirements of third-party insurance payers and accreditation standards.
- Manages the billing process to patients and third-party reimbursement claims; maintain supporting documentation files and current resident addresses.
- Follow up on submitted claims; monitor unpaid claims, initiate tracers and resubmit claims as necessary.
- Monitor billing to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
- Monitor daily releases and correct errors.
- Review and research inquiries regarding coding, charges, and denials on individual accounts.
- Monitor medical records to identify lost revenue through inadequate documentation.
- Prepare periodic reports and trend analysis.
- Prepare special reports and research related projects as designated by management.
- Download electronic payments made to us from carriers
- Assist Demographic personnel as needed to determine patient eligibility
- Process adjustments for Pharmacy for Orange County
- Process bad debts
- Process End of Day and assist to Process End of Month
- Create new computer codes as needed
- Two years college education
- AND 2 years; experience in a medical accounting position
- OR 5 years; experience in a medical accounting position
- Advanced Microsoft Office skills (Word, Excel, Power Point, Outlook).
- Ability to work under pressure
- Knowledge of principles of basic accounting
- Ability to work well with others
- Reports to the Chief Financial Officer
- Able to sit for extended periods of time
- Able to perform repetitive hand and wrist movements
- Able to view a computer monitor for extended periods of time
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