Billing Manager

Job Description

Billing Manager

Fair Haven Community Health Center

Job purpose

Reporting to the Sr. Director of Operations, the Medical Billing Manager will oversee all functions of Fair Haven’s Medical Billing Department to maximize revenues, provide analysis, create written processes and provide training and education efforts of the department.

Duties and responsibilities

The Medical Billing Manager will direct and manage the daily operation of the departmental billing office to ensure the preparation; posting and collections of all billable encounters are completed in an accurate and timely manner. The successful candidate will supervise and facilitate all processes, policies, procedures and be responsible for overall team motivation and effectiveness.

Typical duties include but are not limited to:

• Manages transitions to changing billing and coding environments as they occur through each payor source including Medicaid, Medicare, Commercial, and Private Pay.  Trains billing and clinical staff in use of new codes and establishes new processes to accommodate changes as needed to maintain efficient workflow and uninterrupted collections.
• Maintains current information on Third Party Payors, including thorough knowledge of ICD-10 and CPT codes, and keeps staff informed of insurance provisions & changes.
• Ensures that current fee schedules and billing manuals are being used for all payers billed while adhering to all organizational billing policies and procedures.
• Develops monitoring and tracking systems for billing (e.g. claim rejection) and provides detailed bi-weekly reports.
• Oversees monthly audits of for departmental efficiency and accuracy related to medical coding and payment accuracy and integrity.
• Monitor aged accounts bi-monthly working with staff to address oversights or problems within payers. Ensure staff follow the process to work unpaid claims and backlogs (i.e. credentialing and carrier issues) are reported to be managed promptly assuring appeals are done in a timely manner. Reviews established accounts for bad debt write off.
• Assists the Controller with the monthly accounting close of patient revenues by analyzing billing activity
• Maintains EHR super user status including active participation in user groups, upgrades and staff training as needed.
• Ensures patient confidentiality, and provides patients with needed information as requested
• Hires new billing staff as necessary and completes performance evaluations as required by FHCHC policy.
• Develop and maintains training processes for both new hires and existing staff
• Reviews and recommends updates to FHCHC Billing Policies bi-annually, and as necessary.
• Participates in team meetings both internally and externally as assigned.

Qualifications

Baccalaureate degree and five years of experience in an ambulatory care or practice management setting, including experience in a supervisory capacity is required. A Certified Professional Coding (CPC) certificate and proficiency in billing and finances is also required.

A combination of education and appropriate experience may be substituted for the degree requirement.

Knowledge of medical, behavioral health and dental is essential.  Knowledge and proven experience in non-profit Federally Qualified Health Centers is strongly preferred.

Direct reports

Directly supervises, Medical Billing Coders including Lead, Medical Billing Specialists, Dental Billing Specialist, Behavior Health Billing Specialist

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status