Billing/Data Manager

ESSENTIAL FUNCTIONS OF THE JOB:

• Perform as a practice expert at the department on all issues relating to billing and intake processes
• Supervise the billing department operations; perform duties such as charge entry, payment posting, reimbursement management, insurance verification, claim submissions, and accounts receivable follow-up.
• Carry out audits of current procedures and processes, discover billing operations areas to improve on and effect the necessary actions
• Will participate and work with CFO to complete reports for annual Fiscal Audits.
• Complete the credentialing application and review process for providers.
• Train, allocate work, and resolve problems among billing office personnel.
• Carry out performance evaluation of personnel and recommend necessary actions
• Provide motivation to employees to achieve their best performance and high degree of productivity.
• Ensure quality and appropriate trainings are provided to newly hired and existing billing staff through effective supervision and coordination of the training process, and by adhering to established company operating policies, procedures, systems, protocols, techniques, and standards
• Coordinate time away requests of team members to ensure the daily functions of the department is not negatively affected.
• Carry out analysis of trends affecting coding, charges, accounts receivable, and collection, and assign manageable tasks to billing staff
• Collaborate with other departments to get and analyze additional information about patients to be able to record and process billing effectively.
• Ensure the billing department carries out all its activities in accordance with its overall protocol, and also that they complied with payer, State, and Federal requirements, regulations, and guidelines
• Remain updated on HIPAA and all other health information management issues and regulations.
• Ensure strong team building and protocol in the billing and intake department by holding bi-weekly staff meetings.
• Give report of all concerns and issues at the department to the Director and CFO.
• Carry out completion of the Medicare Cost Report, and other mandated reports due to state and government.
• Other duties assigned for NextGen technical support.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED BY THE POSITION:

• Strong experience of medical insurance/healthcare billing, credentialing, and collections, in a health system or medical practice.
• Possess profound knowledge and understanding of rules and regulations affecting medical billing and insurance verification
• Minimum of 2 years' experience working in a supervisory or management position
• Deep knowledge and understanding of revenue cycle, collections and payment posting, medical billing, Medicare and Medicaid, and third party payers
• Thorough knowledge and working experience of CPT and ICD10 codes, UB04 claim forms, HCFA 1500, HIPAA, medical terminology, appeal processes, billing and insurance regulations, and insurance benefits.
• Solid knowledge of basic accounting principles and business management to be able to effectively give direction to the billing and coding office.
• Profound knowledge of company policies and procedures to be able to provide the right answers to inquiries from all customers (both internal and external)
• Strong negotiation skills to be able to effectively deal with customers and secure payment, as well as to be able to discuss the finances of patients
• Possess current knowledge of technologies in the health information sector and their applications.
• Strong interpersonal skills to be able to effectively relate with the public, patients, organizations, and other employees
• Strong skills in carrying out every part of the work process, i.e. development, implementation, and administration, effectively
• Detail-oriented with the ability to work under pressure and frequent interruptions from staff and patients without being distracted
• Strong ability to communicate effectively with staff, colleagues, patients, physicians, and insurers in person, over the telephone, and in writing
• Strong proficiency in the use of Word, Outlook, Excel, and other Microsoft Office tools
• Strong ability to display exceptional initiative and work under little or no supervision
• Strong ability to train and supervise the work of employees; effectively organize, prioritize, and schedule tasks to ensure practice timelines are met
• Strong ability to handle problems consisting of multiple variables in an organized manner

DESIRED QUALIFICATIONS:

• Bachelor’s Degree in Health Clinic Administration, or;
• 4 + years job experience with EMR systems, Medical, Dental, Contract Health, Third party billing, Data entry, Accounts receivable, Aging, financial, Visit count, Work load, User pop, work flow, reports, Immunization data base, Medical Records experience and training.
• 4 + years job experience with an Electronic Billing Software
• Understanding of medical Terminology
• Documented computer experience with word processing, spreadsheets and database

PHYSICAL REQUIREMENTS:

• Work involves sitting, standing, walking, talking, hearing, using hands.
• Vision abilities required include close vision and ability to focus
• Must be able to sit at a computer workstation for an extended period.
• Ability to reach and squat for filing purposes.