Business Office Manager (Medical)

JOB TITLE: BUSINESS OFFICE MANAGER

DEPARTMENT: REVENUE CYCLE

REPORTS TO: DIRECTOR OF REVENUE CYCLE

JOB SUMMARY:

The Business Office Manager is responsible for managing the revenue cycle to maximize cash flow while maintaining and improving internal and external customer relations. The BOM will also contribute the day-to-day business operations of payor relations, coding and billing/collections for the practice.

POSITION ACCOUNTABILITIES:

· Commitment to perform all job responsibilities in accordance with the philosophy and mission statement of USA. Honest, ethical, professional behavior is a condition of employment.

· Responsible for developing and overseeing payor relations to include credentialing, denials, audits and issues related to payments

· Be a resource for new and current provider contracts as well as making sure they are loaded accurately into the practice management system

· Make recommendations to management regarding contracts language as it relates to claims processing

· Review audit data regarding office and provider coding accurately and sequentially submitted in accordance with government and insurance regulations and performs audits to ensure compliance and follow up with clinical management and provider

· Communicate with other clinical staff/provider regarding the required documentation to support codes submitted and ensures accuracy of technology interface (i.e., MD Coder/GW Link)

· Responsible for oversight of claims submission to insurance companies and ensure proper documentation is provided to maximize collections

· Maintain a working knowledge of insurance to achieve objective of furnishing prompt, accurate information to the correct party to expedite payment of maximum allowable benefits

· Reviews audits/verification of systems utilized to ensure accurate billing practices as it relates to insurance and patient receivables and implements operations of best practice to business office workflow updates

· Responsible for following up with facilities/hospitals on missing data (i.e., operative reports, admission dates, etc.) to appropriately submit claims for maximum collection

· Reviews Patient Financial Counselors workflow against guarantor aging accounts to ensure timely & efficient collections and collections adjustments

· Develop, implement, and maintain Surgery Scheduler and Prior Authorization workflow with productivity measurements and monthly volume analysis.

· Maintains knowledge of and complies with established policies and procedures including government, insurance, and third-party payer regulations

· Performs all other duties as assigned

PHYSICAL REQUIREMENTS:

The physical requirements listed are representative of those that may be faced by a Business Office Manager throughout their scope of employment. To conduct this position properly, applicants must be able to complete the following list of physical tasks. Reasonable accommodation will be available for those individuals with disabilities, and are not able to complete the following tasks.

· Sitting for prolonged periods of time

· Bending and reaching

· Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus as needed

QUALIFICATIONS:

· BS in Business Management, Healthcare Administration or related field of study or active pursuit thereof, preferred

· Minimum of 5 years’ experience in medical insurance billing

· Minimum of 3 years’ experience in a supervisory role

· Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations

· Strong problem-solving skills and ability to make and communicate decisions with a significant attention to detail

· Working knowledge of coding and billing

· Experience with physician credentialing process is preferred

The above duties are intended to describe the general nature and level of work performed. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of an employee so classified.

University Surgical Associates is an at will employer. Your employment with University Surgical Associates is for an indefinite period of time and it is subject to termination by you or University Surgical Associates with or without cause, with or without notice, and at any time

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical billing: 3 years (Required)
• Supervisory: 2 years (Required)

Work Location: In person