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Role Description
The Billing Manager is responsible for overseeing claims production, billing, follow-up, collections, and compliance with third party payer regulations. This position is responsible for both strategic alignment and daily oversight and management of process-based revenue cycle functions, including ongoing improvement to key revenue cycle indicators.
- Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
- Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.
- Provides operational oversight for the Billing Coordinator, mentoring them in their responsibilities.
- Maintains current knowledge of hospital billing systems and government payer systems, including applicable federal/state laws and regulations.
- Demonstrates ability to manage, train and motivate employees, as well as a professional attitude in relating to executive management, professionals and third-party insurance carriers.
- Organizes and leads efforts to maximize operational efficiency and optimize reimbursement.
- Monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.
- Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary.
- Pro-active communication/escalation of potential claims/unbilled accounts/issues to the Director.
- Exhibits excellent leadership and self-direction, good judgement in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills.
- Assures that confidentiality of patient information is maintained without exception.
- Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices.
- Liaise with facility management and operates as the lead point of contact.
- Implements, and monitors the department budget.
- Assures that revenue, expenses, contribution margin and FTE’s meet or exceed budget; prepares and submits budget and related reports; forecasts and accurately projects expenses; takes corrective action to address negative variances.
- Maintain employee time and attendance and scheduling demands.
- Responsible for ensuring employee annual reviews are completed on time and accurately.
- Responsible for accuracy of customer invoices, and creating the invoices monthly.
- Understanding the contract terms and ensuring we stay within those terms.
- Performs all functions from the Management Expectations List.
- Performs all other duties assigned.
Qualifications
- High school graduate or GED equivalent.
- 5 years previous hospital billing experience.
- Working knowledge of insurance regulations, procedure and diagnosis coding and automated insurance billing.
- Excellent communication (written and oral) and interpersonal skills.
- Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow through.
- Must be able to work through issues to resolution.
Requirements
- Associates or Bachelor’s Degree (preferred).
- 2 years Medicare hospital billing experience (preferred).
Benefits
- Work remotely with a work/life balance approach.
- Robust benefits offering, including 401(k).
- Generous time off allotments.
- 10 paid holidays annually.
- Employer-paid short term disability and life insurance.
- Paid Parental Leave.
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