Billing Operations Manager

Description

Position Summary

The Billing Operations Manager will manage the daily operational needs of YYMBC.The position will be responsible for managing client assignments and projects and delivering high quality service.This includes coaching, advising and supporting team members in meeting client and personal development expectations.Assist the President of Medical Billing with personnel administration tasks.

Key Objectives

• Oversees the operations of the billing department including but not limited to: medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, collections, electronic files and reimbursement management
• Assists the President of Medical Billing in the development and implementation of procedures and policies for administrating staff workflow and personnel activities
• Organize workflows, supervise day-to-day activities, and ensure that billing deadlines are met, and payments are maximized
• Educate and trains staff, acts as a professional subject matter expert and mentor to staff.
• Maintain a working knowledge of insurance carriers, payers, and processes utilized within the revenue cycle
• Oversee prospective new client process
• Actively participates in planning, troubleshooting, and processing in various billing areas
• Analyze billing and claims for accuracy and completeness
• Audits current processes and procedures to monitor and improve efficiency of billing and collections operations
• Maintenance and compliance to all HIPAA guidelines/regulations

Qualifications

• Associates in related field or equivalent work experience
• Minimum of three (3) years’ experience in a medical billing, coding, healthcare or related industry
• Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs
• Working knowledge of:
• CPT codes
• ICD-10-CM codes
• HCPCS codes
• HIPAA
• HCFA 1500

Desired Qualifications

• Prefer certification as Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA)

Knowledge, Skills, and Abilities

• Knowledge of the current and future state of the healthcare industry
• Skill in problem solving and the ability to deal with employee issues
• Ability to work under stressful situations

• Ability to adapt to an ever changing business environment including healthcare policies and procedures
• Ability to lead and guide the work of others

• Ability to investigate and analyze information and to draw conclusions
• Ability to communicate efficiently and effectively both verbally and in writing
• Ability to handle multiple tasks and meet deadlines

Business Development

• Manage client accounts to ensure customer service needs are being met
• Expand sales within existing accounts

Leadership

• Reports to President of YYMBC
• Supervise medical billing staff; overseeing both personnel and work activities
• Evaluate performance of medical billing staff annually
• Provide guidance and support in career development opportunities for staff including training opportunities and feedback
• Establish and maintain sound working relationships with peers, supervisors, and clients
• Review employee timesheet details and report weekly on employee technical accuracy
• Work with the Talent Manager to recruit, develop and retain high performing employees

Technology

• Coordinate with vendors to ensure seamless implementation and continual maintenance of systems

• Train, implement and oversee software used within the organization:
• Clearinghouse software
• Medical Billing software
• Data management workflow software

Physical Demand

• Frequent use of hands, wrists, fingers associated with computer equipment.
• Required to sit for extended periods of time.
• Occasionally stoop, kneel, crouch or crawl.
• Normal visual acuity, ability to talk and hear.
• Occasionally lift and/or move up to 20 pounds.

Working Conditions

• On-site position
• Normal office environment
• May on occasion be exposed to loud sounds and distracting noise levels, such as from office equipment.