Practice Manager - Medical Billing

reCLAIM Mission

Our employees are like family, and company culture is paramount for us. We reward our staff and encourage team building and professional development. We invest in the stock of our employees, and growth is the hallmark of our business model. We want you to enjoy coming to work, and we are looking for long-term employees. reCLAIM Billing Solutions believes in an equal opportunity for each applicant and encourages diversity!

We welcome all who want to join our team!

Position Description

The Practice Manager (PM) is the liaison between the medical practice and the reCLAIM team. The PM provides exceptional customer service to their customers by being responsive (at times even while away from the office), informative (by staying up to date on healthcare industry changes), and organized (by researching answers for gaps of knowledge). The PM works denials and follows up on claims status at a lesser quota than the rest of their team. This is to encourage the PM to gain a boots-on-the-ground understanding of their account. The PM also manages projects to their completion by managing the effectiveness of their team. The PM will be trained on industry standards but also must stay informed on industry standards through self-discovery.

Practice Management & Maintenance

1. The PM will create a project workload to monitor and work the goal number of claims, with the status of denials or no response (claims that need follow-up). They will effectively be responsible for whether these projects are completed by their due dates.

2. The PM will meet with their team, both onshore and offshore, upon completion of either the denial or no response report and brainstorm plans to reduce the amount of workload. The PM will then put these plans into action to reduce denials and claims that need follow-up.

3. The PM will identify denial trends and build and monitor practice rules to ensure that the client’s account is running efficiently.

4. The PM will work with their team to ensure a rate of less than an average of 1.5% write-off rate each year for our clients.

5. The PM will monitor and manage their offshore and onshore team to ensure that they are fulfilling their position responsibilities and duties.

6. The PM will enter data and numbers to help track the number of claims that are worked on and/or entered. The PM will use these numbers to help determine the health of their accounts and keep their numbers in line with the company’s benchmarks.

7. The PM will monitor the data entry done by the charge entry team to ensure that patient visits are being billed in a timely manner with minimal mistakes.

8. The PM will monitor the credentialing tasks / applications performed / completed by reCLAIM for their clients and ensure that those tasks are being completed in a timely manner. The PM may communicate the status of these tasks / applications to the client on behalf of the credentialing team.

9. The PM will monitor for payment errors and mistakes made by the payment team and communicate them to their Quality Assurance (QA) manager.

10. The PM may mentor an extern or externs if the extern is assigned to them. The PM will determine if the extern(s) are eligible for hire and may recommend them to HR.

11. The PM will attend hiring sessions pertaining to their onshore team and contribute to whether they think the candidate should be added to their team or not.

12. Maintain and monitor trainings and processes that pertain to the PM’s position.

Client Relations

1. The PM will work with their QA Manager to provide clients with their quarterly reports. At which time, the PM will answer any questions or concerns that the client may have regarding their reports.

2. The PM will answer questions and requests from clients and correspond with any internal members to obtain the answer, if not already known by the PM. After obtaining an answer, the PM will communicate this answer on behalf of the relevant internal parties. The PM should not forward the client to an internal member because they do not have the answer to the question.

3. The PM will provide office, provider, and internal staff training of proper procedures and processes to ensure a 95% collection rate.

4. The PM will meet in person or via online conference with the practice’s office manager and/or owner upon request and may form a monthly standing meeting.

5. The PM will receive Work Order Forms from the practice and ensure that onboarding is started. The PM will then monitor the onboarding process until it is completed.

6. The PM will meet with new clients during onboarding and provide training to help teach them best practices and procedures.

7. The PM may answer patient correspondence if the practice requests that the patient speak with their PM.

8. The PM will ensure that any client checks are deposited into the authorized client bank account or transferred to the client and that no checks are lost, stolen, or misplaced while being handled internally.

9. The PM will correspond via phone, email, and/or fax with clients and insurance agents in a timely manner (24 hours from the last business day).

10. The PM will prepare and send accurate month end collection reports to accounting for review and, upon approval, send the approved reports to clients for review.

Position Requirements

Technical Skills

· 2 years in relevant experience

· Bachelor’s degree (preferred)

· Certified Professional Coder (CPC) (strongly preferred)

· Basic understanding of rule generation and syntax

· Advanced Revenue Cycle Management (RCM) knowledge

· Advanced computer skills (Microsoft 365, and Adobe)

· Previous experience with managing multiple practices’ revenue

Other Skills

· Critical thinking and problem-solving skills

· Meticulous at note taking and organized

· Drive to generate results

· Fast learner

· Ability to work in fast-paced environment and maintain a sense of urgency through time management and multi-tasking

· Client-centered mentality and passion for customer service

· Strive for continuous improvement and career advancement

· A strong communicator

We Are Looking for Team Members Who Are

· Organized and detail specific

· Proponents of logic and reason

· Self-starters in achieving goals

· Enthusiastic and hungry for growth

· Team players who also take instruction well

· Proactively seeking work to complete, while meeting company expectations

· Maintain updated knowledge of the healthcare industry and learn the new policies set by insurance companies

· Organized in performing company tasks and executing the goals set by management

· Punctual and prompt to their responsibilities

Compensation & Perks

Starting Salary: $50,000-65,000 salary (bonus structure for hitting company benchmarks)

Medical benefits: Anthem HMO and PPO network health plans offered with wide-ranging benefits

Dental benefits: Renaissance Dental with PPO network

Vision benefits: Renaissance with VSP Vision Care network

Supplemental coverage: Hospital Indemnity, Accident Expense, and Short-Term Disability Income

Retirement benefits: 401K retirement plans

Other benefits: PTO accrual 40 hours per year (2,080 worked hours). 16 hours of sick time annually.