Billing Department Manager, OPA–Anchorage, Full-Time

Orthopedic Physicians Alaska seeks a highly skilled, dedicated, and professional individual to join our rapidly growing and dynamic team as a Billing Department Manager.

The Billing Department Manager is an exempt position that reports directly to the Director of Revenue Cycle Management. The position requires a positive, personal rapport with RCM leadership and staff and plans and leads with RCM leadership and support personnel. This individual reports progress and benchmark indicators to the Director of Revenue Cycle Management on a monthly basis and is responsible for the day-to-day operations of all Billing Department processes.

At OPA, employees enjoy work-life balance, competitive salaries, and comprehensive medical, dental, FSA or HSA, life, and disability insurance, as well as profit sharing, 401(k), and paid time off starting at three (3) weeks per year. Learn more about Orthopedic Physicians Alaska at www.OPAlaska.com.

Ideal attributes
• Strong interpersonal communication skills (phone, written, verbal)
• Strong servant leadership skills
• Ongoing technical education in RCM processes and systems
• Strong leadership skills to help motivate employees and help grow a team environment

Essential job responsibilities
• Work closely with RCM Director to assure practice expectations for the department are met.
• In collaboration with billing team leads develop and update new employee training guide.
• Maintain reasonable volume of unapplied credits and timely refunds from D.O.S.
• Oversee and ensure of timely claim submission that follow practice guidelines.
• Oversee and ensure that the days payment postings are timely and closed within 48 hours of payment(s) receipt. In time of high volume communicate to RCM Director of expected reconciliation date.
• Plan and direct patient insurance, billing and collections, pre-cert and data entry to ensure accurate patient billing and efficient account collection.
• Review past due patient accounts with staff to identify and resolve billing and processing problems are resolved in a timely manner. Monitor patient accounts with high balances to resolve within a maximum of 24 months.
• Know and implement a system for the collection of delinquent accounts ensuring third-party payers are contacted. Work with outsourced billing company lead to review concerns.
• Establish and recommend credit and collection policies. Make recommendations for improvement.
• Maintain contacts with medical records and other departments to obtain and analyze additional patient information to document and process billings.
• Develop and oversee billing and posting systems and work with information technology to ensure timely and accurate implementation. Evaluate for possible improvement and propose solutions.
• Oversee appeal process to ensure timeliness and ensure appeals are generated to address specific denials.
• Oversee and ensure that pre-authorizations and provider notifications are timely, and documentation is accurate.
• Oversee pre-certification process and timeliness of prior authorizations. Monthly meet with pre-cert staff.
• Work closely with coding and auditing manager to ensure processes are in line with both departments for accurate coding.
• Responsible for the development and leadership of assigned team members, including annual performance reviews, development checks-ins and compensation review feedback.
• Responsible for the success of the department by weekly or bi-weekly one-on-one meetings with billers, patient representatives and financial counselors.
• Manage staff overtime.
• Demonstrate competency in working in teams and the ability to effectively communicate at all levels.
• Participate in the hiring process for the billing department and ensure new employees are trained, developed and contributing members of the team.
• Meet with RCM Director monthly to collaborate as well as review month-end reports, and all other items, concerns as needed.

Knowledge and skill requirements
• Strong knowledge of revenue and employee management
• Strong knowledge of billing and coding rules for health care
• Strong knowledge of healthcare payer contract compliance concepts and standards
• Proven experience in billing, coding, fee schedule evaluation, and regulatory compliance
• Knowledge of CMS guidelines for DME billing
• Intermediate-level skills with Microsoft Excel
• Ability to navigate payer websites and interpret payer fee schedules

Required qualifications
• Minimum of five (5) years medical office management and leadership experience that includes Billing Department processes
• Medical coding certification(s) and experience
• Familiarity with Drug Code Units and ASP calculations, and with payment posting and balancing processes

• Bachelor’s degree in health care management or business; experience may substitute for degree when combined with Associate Degree relevant to management or equivalent

The mission of OrthoAlaska, Orthopedic Physicians Alaska division is to provide the finest orthopedic surgery and musculoskeletal care in North America through quality, patient-centered care. Each of our physicians and surgeons works in concert with a certified orthopedic surgical physician assistant and other staff to provide patients an individualized care-team experience. Currently, we have offices in Anchorage, Wasilla, and Eagle River.

Employees enjoy opportunities for professional growth in a collaborative environment and exposure to a full range of orthopedic care with orthopedic, injury walk-in, and rheumatology clinics, an imaging center, athletic training and physical, occupational and massage therapy.

OPA values quality, patient-centered care, personal fulfillment through continuous improvement, team development, and community service. We welcome applicants who embrace our same core values and possess a daily renewed attitude of excellence.

OPA benefits include health and dental insurance, life and disability insurance, 401(k) and profit sharing, as well as paid time off.

OrthoAlaska is proud to provide equal employment opportunities to all applicants and employees without regard to race, color, ancestry, national origin, sex, sexual orientation, gender identity, marital status, religion, age, pregnancy, protected veteran status, disability, or other protected categories.