SUMMARY: Responsible for developing, planning, organizing, and implementing current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow and manage the overall health of ARMS’ receivables. Also, responsible for managing the day-to- day activities of ARMS as they relate to revenue cycle functions which include but not limited to front office services, billing, collections, accounts receivables and financial planning for patients.

ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE THE FOLLOWING: (other duties may be assigned:

1. Develop strategic plans and programs for the Revenue Cycle team and ensures that goals and objectives of the team are properly defined and clearly established.

2. Develops policies, guidelines, and procedures and ensures consistent company-wide implementation.

3. Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivables are no more than the agreed upon limit and that bad debt is within budgeted target.

4. Selection and training of new employees for Front Desk and the Billing & Coding
Departments.

5. Perform employee audits.

6. Monitoring of acceptable work flow/work load and ongoing record review for quality documentation.

7. Manage patient complaints so immediate resolution can take place. Refer all complaints to
Compliance Officer and follow up to insure timely and consistent patient satisfaction.

8. Manages and oversees the patient services and billing staff in handling patient relations.

9. Develops and formulates performance measures and standards for the team, as basis for the conduct of annual performance management.

10. Review documentation completed by providers, including CPT and ICD codes on health claims/encounters and review electronic medical records to ensure documentation sufficiently supports the claim and related codes.

11. Ensure diagnoses and procedures correlate and thoroughly understands modifier usage.

12. Resolves error reports as associated with billing process, identify and report error patterns, and when necessary assist in design and implantation of workflow changes to reduce billing errors.

13. Accurately codes conditions and procedures as documented in the ICD Official Guidelines for coding and reporting.

14. Keep apprised of industry coding standards, monitors changes and educates staff.

15. Provide thorough, timely and accurate ICD and CPT-4 HCPCS coding.

16. Contact providers or clinic staff to clarify information when necessary.

17. Maximizes the company’s billing and collections efforts

18. Provides consultation to the billing department and recommends appropriate process improvements and/or changes

19. Monitors company procedures, code usage and claims processing to ensure the company is earning revenue

20. Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and works cooperatively and jointly to provide quality seamless customer service

21. Produce and analyze monthly AR reports that assist the monthly forecast process.
22. Compiles and prepares various status reports for management in order to analyze trends and make recommendations.
23. Oversees documentation systems to assure medical documentation.
24. Reviews and revises billing procedures as needed and communicates continued changes in coverage issues.
25. Ensures adherence to all state and federally mandated documentation standards
26. Performs technical analysis of payer activity
27. Evaluates and resolves system problems
28. Reviews, coordinates and updates all medical billing compliance issues
29. Perform other duties as assigned.

QUALIFICATION REQUIREMENT:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

EDUCATION and/or EXPERIENCE:

Associates Degree with at least 5 years of experience in coding, required.
CPC Certification through AAPC, required.
3 years of Supervisory experience, preferred.

OTHER SKILLS AND ABILITIES:

Good writing skills and able to think analytically
Knowledge of medical terminology and health insurance billing
Working knowledge of MS Office Suite, including Word, Outlook, Excel, and PowerPoint
Demonstrated oral communication skills
Proven track record in interdependent function with others and in promoting teamwork

Ability to organize, communicate effectively and knowledge of general corporate operations
Extensive knowledge and use of electronic medical record system (EMR), and automated accounting and billing systems required.