Location
Louisiana | United States
Job description
GENERAL SUMMARY OF DUTIES: Manages patient account and reimbursement services for the agency that requires third party and other billing related functions; developing, implementing, and enforcing policies and procedures, as well as streamlining effective billing processes (with the exception of grants and contracts). This position is highly visible and requires a strong leader with the ability to prioritize, plan, manage, follow-up, report, communicate, and direct the department. Proven track record for improving process efficiencies and solving problems.
SUPERVISION EXERCISED : Manages the Billing Department-Revenue Cycle Management, Days in AR, Reconciles and identified front end and back-end issues and escalates appropriately. The Billing Manager is responsible for the overall management, condition, and evaluation of the Revenue Cycle; also, directly supervises non-supervisory employees who support the revenue cycle process. Carries out managerial responsibilities in accordance with the agency’s policies and applicable laws; responsibilities include interviewing and training employees, planning, assigning and directing work; appraising performance, rewarding and disciplining employees, addressing complaints and resolving problems.
ESSENTIAL FUNCTIONS: The manager will perform the following duties personally or through subordinates.
- Oversee and optimize centralized billing operations, supervising all related roles for Medical and Dental Billing that’s comprised of Central Office Billing.
- Formulate, assess, and update billing and reimbursement policies and procedures based on changes in laws, policies, and under the advisement of supervisory and executive staff.
- Maintain confidentiality and adherence to standard accounting practices in accounts receivable.
- Uphold stringent internal control measures over accounts receivables.
- Secure cash payment processes and assure all processes are followed.
- Track and manage collections, insurance claims, and third-party payments.
- Analyze and ensure compliance with third-party reimbursement policies; investigate discrepancies.
- Stay current with billing policies and third-party contracts, private insurers, and government regulations.
- Problem solves operational issues and customer service issues that may be experienced with clinic and operations staff.
- Ensure that all critical issues are escalated to the Director of Finance.
- Support training and communication initiatives for Front Desk operations, Practice and Operations Management, and providers.
- Collaborate with external stakeholders for financial studies and audits concerning patient accounts.
- Manage charge postings, denials, billing, and collections for outpatient services, enforcing consistent policy application.
- Develop and conduct staff training and development programs to include evidence of gaining new knowledge.
- Organize staff schedules to guarantee optimization of the revenue cycle based on size, scale, and scope of the medical and dental practices.
- Host departmental meetings to communicate procedural changes as often as necessary.
- Collaborate with the financial and executive leadership on issues that impact the organizational budget and organization’s strategic plans.
- Conduct research and procurement for necessary business tools or business intelligence that support and enhance the department.
- A liaison between the department and other departments as needed to insure the best billing practices and compliance across the organization.
- Meet with the clinical and credentialing department regularly to insure they are aware of any issues related to denials or coding.
- Ensure that activities of the department align with the organization’s budget and strategic plans.
- Compile and present detailed reports and analyses on billing, collections, and reimbursements.
- Participate in HRSA, Joint Commission, and other accrediting bodies on all audits that occur in the organization.
- Implement metrics and KPIs (Key Performance Indicators) to monitor and report on the efficiency and effectiveness of billing operations.
- Develop strategies for reducing the time from service delivery to payment receipt.
- Engage with IT department to leverage technology in improving billing processes, ensuring system optimization and data integrity.
- Foster a culture of continuous improvement, encouraging innovation and efficiency in billing processes.
- Evaluate customer satisfaction regarding billing issues and develop strategies to enhance the patient financial experience.
- Ensure compliance with HIPAA and other relevant regulations concerning patient financial information.
- Prepare and present billing department status reports to the Director of Finance and CFO monthly.
- Mentor and develop billing department staff, fostering a team-oriented environment.
- Fulfill additional responsibilities as designated by the CFO or CEO.
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, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION/EXPERIENCE :
Bachelor’s degree from a four-year college or university in Finance, Business Administration, Health Information Management, or a related field; or an equivalent combination of education and experience in a relevant area.
A minimum of three (3) years of direct experience in billing and coding, with a strong emphasis on practical application and hands-on training in this field. Current certification as a Certified Biller and Coder, with a commitment to maintaining this certification and staying abreast of industry changes.
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