Billing & Collections Manager

Description

Position at BayMark Health Services

Billing and collections manager

Job Summary

Under the general direction of the Vice President of Revenue Cycle Management, the Billing/Collections Manager will oversee the accounts receivable, claim submission and collection functions assigned. Manager will be responsible overseeing Billing Supervisors and Billing Leads, ensuring proper process flows and efficiencies of all sub-divisions of the -Revenue Cycle Management (RCM) team, final review of RCM reporting which includes reporting monthly revenue to Accounts Receivable team no later than the 7th business day of each month, reporting AR trends to the VP of RCM, identifying and finding resolutions of claim problems and ensuring that outstanding AR over 90 days is below 15%. Additionally, the Billing and Collection Manager will ensure that Billing Supervisors submit accurate and timely claims of all patient/customer billing to Medicaid, other third party payers and private payers, accounts receivable tracking and follow up activities and collecting past due accounts from Insurance Payers.

Responsibilities

• Oversee and assist (when needed) billing and processing claims.
• Final review of and approval of delinquent accounts to include preparation of patient refunds and write-offs including proper documentation for bad debt.
• Review and submit financial and collection effort data.
• Act as an authority to escalate a variety of correspondence from patients and their representatives, insurance companies, attorneys and administrators of estates regarding billing, insurance and payments when not able to be resolved at the Billing Lead or Billing Supervisor level.
• Act as an authority to escalate and interview or telephone concerned parties regarding delinquent accounts or unusual collection problems when not able to be resolved at the Billing Lead or Billing Supervisor level.
• Act as a liaison with clinic supervisory personnel to coordinate collection efforts and resolve problems when not able to be resolved at the Billing Lead or Billing Supervisor Level.
• Create training materials for RCM staff and treatment center staff when appropriate (i.e. retraining treatment center staff on Insurance Eligibility, training RCM staff on EHR systems).
• Implementation and rollout of new insurance carriers to RCM staff, treatment center staff, Regional Operators.
• Communicate changes in payer structures to staff, treatment center staff, Regional Operators.
• Review reports provided by Billing Leads and Billing supervisors and analysis and confirm accuracy for month end close.
• Maintain outstanding 90 AR below 15%
• Ensure that all final month end reporting and invoices are submitted to Accounts Receivables Department no later than the 7th business of each month.
• Participate in performance improvement activities that ensure important processes and activities are measured, assessed and improved systematically.
• Maintain all security passwords given to him/her.
• Maintain storage of all electronic data essential for functioning on the server.
• Demonstrate and communicate a complete knowledge of internal systems, reports/databases, and HR policies, as well as, performance expectations and standards.
• Assist in training new employees to ensure knowledge and skills essential for effective job performance are acquired.
• Provide continuous training and education to all staff to new departmental policies and changes in insurance requirements/regulations, etc.
• Perform regular assessments for each employee and provide constructive feedback to include action plans for improvement as needed.
• Assist in hiring activities, evaluating employee performance and disciplinary actions/termination when necessary.
• Keep staff and patient information within the HITECH HIPAA privacy laws.
• Ability to handle stressful situations and interact with others.
• Must be present during working hours at the office for in person meetings and access to a computer without violating company policy.
• Comply with policies, procedures, compliance guidelines and Code of Conduct.
• Comply with internal controls, policies and procedures.
• Comply with BayMark policies and procedures, Compliance Policy and Code of Ethics.
• Conduct all business activities in a professional and ethical manner adhering to medical necessity compliance and financial compliance.
• Regular attendance is to be maintained.
• Interact with all levels of the organization in a positive and motivational fashion supporting the Company’s mission.
• Perform and complete special projects as assigned for all BayMark regions and billing modalities.
• Travel by plane or by car as required.
  
  

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The employee will be required to perform other reasonable related duties as assigned.

Qualifications

• High School Diploma.
• Minimum of five years’ experience in healthcare billing and collections is required.
• Behavioral health or substance abuse experience a plus.
• Must be able to analyze, record, and summarize fiscal transactions and prepare spreadsheets/financial statements.
• Requires the performance of calculations involving basic arithmetic skills, good degree of verbal and written communications and the ability to give/follow oral and written instructions.
• Must have strong working knowledge in third party billing and reimbursement with an emphasis on Medicaid.
• Candidates must have experience in medical terminology as it relates to our business, OTP coding and know thoroughly the authorization process.
• Working knowledge of different MCO authorization requirements
• Excellent verbal and written communication skills
• Data entry experience.
• Ability to fill in for other employees as needed.
• Compliance with all HIPAA policies
• Proficient in basic PC skills. Microsoft Word and Excel required
• Ability to multi-task and handle large volume of detail work accurately and efficiently and meet deadlines.
• Compliance with accepted professional standards and practices
• Satisfactory references from employers and/or professional peers
• Satisfactory criminal background check
  
  

Benefits

• Competitive salary
• Comprehensive benefits package including medical, dental, vision and 401(K)
• Generous paid time off accrual
• Excellent growth and development opportunities
• Satisfying and rewarding work striving to overcome the opioid epidemic
  
  

Here Is What You Can Expect From Us

BayMark Health Services, a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient and inpatient clinic setting.  Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.  

BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran’s status or any other classification protected by State/Federal laws.