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3236

Medical Billing Manager

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Job Title:

Medical Billing Manager

Job Purpose:

This salary position reports to the Business Manager and the provider physicians. This position is vital to the overall accuracy of the coding, billing and reimbursement functions. Serving as the liaison between providers and staff, this role insures the necessary knowledge and support required to meet industry standards regarding compliance, HIPAA regulations, coding applications and payer imperatives. 

Job Responsibilities:

• Maximize collections while working with patients with warmth and respect
• Operates independently; Trains and supervises billing staff
• Coordinates and tracks the work flow necessary to produce claims, post all charges, adjustments and payments as appropriate, maintain integrity in the books and properly address all patient and payer inquiries.
• Disseminates coding and payer information to providers and staff as updates are received
• Reviews provider documentation as required to support the billed charges and in accordance with the processed authorizations
• Interacts with software vendor to identify and/or improve system functions
• Captures all missing charges and post to patient accounts
• Appeals, as appropriate, all denied claims
• Reviews all rejected claims, edit and resubmit as appropriate
• Routinely audits accounts for overall accuracy
• Serves as Practice Administrator/Security Officer for all contracted insurance web portals responsible for maintaining & monitoring practice/provider profiles and user access
• Identify content and schedule presentations for on-going educational administrative and provider staff training sessions/documents as it applies to coding and reimbursement
• Identifies key issues pertinent to the overall effectiveness of the proper induction of patients to the practice from check-in through the completion of the billing process
• Identifies accounts that are in pre-collection or collection status
• Facilitates transferring identified and reviewed accounts to the collection service with approval from the Business Manager and the provider physicians
• Insures monthly reconciliation of accounts

Job Requirements:

• In-depth experience coding several different disciplines
• In-depth knowledge of CPT, ICD-9 and ICD-10 coding
• Excellent problem-solver regarding coding, billing and reimbursement issues
• Strong written and oral communication skills, including the ability to facilitate communication and coordination with the internal teams as well as patients, payers, and service agencies
• Knowledge and application of HIPAA requirements
• Experience with medical practice software coupled with the ability to learn and apply system updates

Qualifications:

• Minimum of ten years’ coding and billing experience
• Current CPC certification
• Strong foundation in and successful results with payer appeal processes both commercial and government
• Excellent customer service skills
• Professional skills required to successfully support the coding, billing and reimbursement effort
• Ability to manage staff in all aspects of the coding, billing and reimbursement functions

FLSA Status: Non-Exempt
Department: Billing
Reports To: Business Manager and the provider physicians

 


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