Manages medical billing staff and payer billing and collections processes, ensuring accurate, timely reimbursement. Oversees performance management, billing issue resolution, aged receivables reporting, payer compliance, staff training, and process improvements. Partners with clinical, operations, quality, insurance, and senior leadership teams to improve billing efficiency, reduce bad debt, address non-billable services, and maximize reimbursement opportunities.
Role and Responsibilities
The Billing Manager position is a member of the Billing Team which reports up through the Finance Department. The Billing Manager is considered a critical point-of-contact for the Billing Team and assists the manager in making improvements to reporting and billing processes, including cross-training functionality with the Insurance Team.
Essential Functions
- Direct billing staff in the proper procedures for billing and collections for a variety of payers, including but not limited to Medicare and Medicaid.
- Responsible for performance management of staff including but not limited to job coaching, annual performance evaluations, attendance, etc.
- Handle/direct customer questions and concerns regarding service charges in a highly professional manner.
- Ensure error free billing is completed within specified time frames as required by respective payers.
- Assess billing problems and issues with respect to both internal and cross-departmental procedures.
- Works closely with managers and staff across the organization including senior leadership team members to assess problems and recommend efficiencies and improvements relating to the integration of billing requirements and computer software capabilities necessary to increase reimbursement opportunities.
- Provide regular reports to management and senior leadership concerning patient and insurance aged receivables.
- Work to improve reporting efficiencies and the quality of data distributed.
- Works closely with Quality and Operations Managers to eradicate bad debt and educational opportunities to increase reimbursement opportunities.
- Immediately address and correct problems related to non-billable services, involving senior management when necessary.
- Maintain ongoing training for professional staff, either regularly or as needed, with respect to services covered by payers and what protocols must be followed to ensure proper authorizations for projected visits.
- Other duties as assigned.
This job description reflects management’s assignment of essential functions; and nothing in this herein restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Education Requirements
- Bachelor Degree in Business (Required)
- 3+ years in health care and supervisory experience
- or Associate Degree in Business with 5 years health care and supervisory experience
Qualifications and Requirements
- Minimum of five years of medical billing experience required.
- Prior supervisory experience in a healthcare billing environment preferred.
- Role model ability to maintain and protect confidentiality.
- Knowledge of CPT, ICD-9, ICD-10, HCPCS Coding and Insurance reimbursement codes, payment structures to include fee-for-service and prospective payment systems.
- Experience in preparing reports for staff and management.
- Experience with a high-level of interaction and demonstrated professionalism with clinicians, management, insurance companies, and staff.
- Adept in applying remittance payments and adjustments.
- Knowledge of New York State Medicaid and/or Medicare.
- Strong problem-solving/trouble-shooting skills.
- Consistent, strong interpersonal and communication skills while interacting with customers, co-workers, clinicians, staff, insurance company representatives, and management.
- Consistent demonstration of positive, compassionate, and welcoming behavior.
- High-level of independence with little to no supervision.
Work Environment
The Billing Manager is primarily in an office setting and may be exposed to outdoor conditions.
The working conditions are classified as sedentary work:
- Sedentary work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
Physical Requirements
The following is a description of the physical requirements on a daily basis for the Billing Manager. While performing the duties of the job the employee is regularly expected to:
- Stand
- Sit
- Hear
- Walk
- Talk
- Stoop or kneel
- Repetitive motion
This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed as assigned.
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