JOB TITLE: Billing Manager

REPORTS TO: Clinic Manager and CEO FLSA 

FSLA: Exempt, salaried management position

Job Summary:

Directs and coordinates the overall functions of the Billing Office to ensure maximization of cash flow while improving patient, provider and payer relations. The Billing Manager supervises the billing office staff and assists the front desk staff when needed.

Primary Job Duties: 

• Plan and direct registration, patient insurance, billing and collections and data processing to ensure accurate patients billing and efficient account collection. 
• Manage the Billing Office within the established budget including annual planning and status reports. 
• Review current status of patient accounts to identify and resolve billing and processing problems in a timely manner. 
• Establish and implement systems for the collection of delinquent accounts with third-party payers as well as patient balances. 
• Prepare and analyze accounts receivable reports, weekly and monthly financial reports, and insurance contracts. 
• Establish and recommend credit and collection policies including recommendations for improvement. 
• Develop and implement new procedures to improve the quality and quantity of work processed. Ensure policies are communicated and administered consistently. 
• Develop and oversee business systems and work with IT to ensure timely and accurate implementation. 
• Responsible for the provider credentialing/re-credentialing process. 
• Maintain on-going contracting with third party payers. 
• Supervise, train, orientate and evaluate performance of Billing Office staff. Recommend merit increases, promotions and disciplinary actions. 
• Provide, oversee, and/or coordinate the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques. Monitor daily operating activity of department and make necessary adjustments in work assignments and flow. 
• Initiate and answer pertinent correspondence. Prepare and write reports. 
• Maintain required records and files
• Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements. 

• Understand and remain updated with current coding and billing regulations and compliance requirements. 
• Attend administrative meetings and participate in committees as required/requested. 
• Conduct special projects and studies as directed including QI audits. 
• Participate in professional development activities and maintain professional affiliations. 
• Maintain strictest confidentiality.

Education: 

• Graduate of an accredited billing management program. 
• Associate degree in Business Administration or related field. 
• Baccalaureate degree in Business Administration or related field preferred

Licenses/Certifications: 

• Certified Professional Coder (or equivalent) required. Experience: 
• Minimum of five years medical billing experience required. 
• Two years medical billing management preferred. 
• A combination of education and experience will be considered. 

Knowledge: 

• Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of State and Federal payer regulations. 
• Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes. 
• Knowledge of basic accounting principles required to direct the billing and coding office. 
• Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers. 
• Possess excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a health care setting. 
• Current knowledge of health information technologies and applications.

Skills: 

• Ability to establish and maintain effective working relationships with other employees, patients, organizations, and the public. 
• Ability to develop, implement, and administer work processes. 
• Detail oriented and tolerant of frequent interruptions and distractions from patients, providers and staff. 
• Effectively communicate with providers, patients, payers, colleagues and staff. 
• Excellent Customer Service skills and ability to effectively work with irate patients.