Billing Manager

 

The Manager of Billing and Posting is responsible for demonstrating knowledge of the billing and posting teams core processes and functions, reporting accurate information to insurance companies, and overseeing all billing, posting, and credit matters. This position requires extreme attention to detail and critical thinking and will work closely with the VP of Revenue Cycle, Leadership, Billing Team, Posting Team, and Credit Specialists as well as other departments across the organization.

Responsibilities

include the following. Other duties may be assigned.

-Ensure execution of core processes, identify process improvements needed for efficiency and improvement, implement solutions, and continuously audits to ensure compliance-Work and communicate directly with executive leadership on projects, challenges, and changes relating to billing and collections regularly-Main contact for billing platform and EMR issues, changes, and updates

-Work interdepartmentally to communicate and resolve billing/collections issues including working with VP of RCM and all other department leaders and employees-Draft and update procedures relating to billing/collections-Assist Posting Supervisor with month end close-Understands and remains updated with industry best practices, current coding and billing regulations, and compliance -Accountable for being knowledgeable and understanding of all aspects of the billing and posting staff duties to include: -Billing of accurate clean claims by attaching necessary documentation for payment charges according to insurance payors/contracts-Follow-up on electronic claims and paper claims -Posting insurance payments to patient accounts-Audit the payment posting to ensure accuracy and timeliness-Submit all secondary claims when necessary -Refund money owed to insurances-Analyze claims and billing data to identify trends and examine claim denial issues.-Follow up with third party organizations after careful review of claims with overpayment/recoup requests.-Oversees the day-to-day duties of the billing and posting team-Lead, manage, retain, and hold team members accountable-Coach, mentor, and train team members based on established processes.-Maintain accurate monitoring methods to ensure deadlines are being met consistently.-Manage team schedules to ensure coverage on all accounts, including planning for coverage during scheduled absences.-Maintain regular documentation of direct reports performance and results from audits to provide written feedback in scheduled 1:1, quarterlies, and annual reviews.-Take ownership to resolve escalated issues from direct reports and agencies. -Develop and analyze reports that provide dashboard of key metrics within department to be reviewed with leadership.-Actively participate in internal quality improvement teams and work with members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards, when assigned.-HIPAA: Keep all protected health information (PHI) confidential and abide by HIPAA guidelines for the release and disclosure of any PHI. Will report unauthorized use of disclosure of PHI immediately.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Essential Skills: To perform the job successfully, an individual should demonstrate the following:-Professionalism – Arrives and begins work prepared and on time. Keeps absences within guidelines. Schedules time off in advance. Keeps commitments. Completes tasks within required guidelines. Displays positive outlook, pleasant manner, and professional appearance. Establishes and maintains effective relations. Works actively to resolve conflicts.

-Teamwork – Balances team and individual responsibilities. Contributes to building a positive team spirit. Puts success of team above own interests. Works cooperatively in group situations in commitment to changing the world for children with autism. 

-Communication - Exhibits good listening and comprehension. Expresses ideas and thoughts respectfully in verbal and written form. Keeps others adequately informed. Selects and uses appropriate communication methods. Edits work for spelling and grammar. Presents numericaldata effectively. Varies writing style to meet needs. Writes clearly and informatively.

-Problem Solving - Develops alternative solutions. Identifies and resolves problems in the early stages and solves them in a timely manner. Displays willingness to make decisions. Exhibits sound and accurate judgment. Includes appropriate people in the decision-making process. Supports and explains reasoning for decisions. Uses authority appropriately to accomplish goals.feedback. Listens and gets clarification. Participates in meetings. Responds well to questions. Speaks clearly and persuasively.

-Achievement Focus - Demonstrates persistence and overcomes obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals.

-Leadership Management - Delegates work assignments. Gives authority to work independently. Matches the responsibility to the person. Provides recognition for results. Sets expectations and monitors delegated activities. Builds commitment and overcomes resistance. Communicateschange effectively. Prepares and supports those affected by change.

-Strategic Thinking - Adapts strategy to changing conditions. Analyzes market and competition. Develops strategies to achieve organizational goals. Identifies external threats and opportunities. Understands organization's strengths and weaknesses.