Manager, Billing and AR Follow-up - 40hrs

The Billing Manager oversees the billing operations for hospital/professional services. Under minimal supervision of the Director of Revenue cycle the Billing Manager coordinates and manages the revenue cycle functions, including but not limited to billing, insurance follow up, cash application, patient credit balances, denial management, mail, scanning, data entry and other miscellaneous functions. The Manager provides direction and support to staff, promotes staff development and collaborates with other managers, directors and administrative staff to ensure operations function in a safe, effective, and fiscally responsible manner.

The Manager monitors key metrics and reports to ensure all activities are being completed by staff timely and accurately. This position is responsible for monitoring collections and denial trends specifically significant changes and/or any anomalies. This position monitors and interprets reports, including denial reports, monthly A/R reports and all other reports as necessary. The Manager ensures the accuracy of net revenue and the timeliness and appropriateness of billing and collections.

The Manager conducts quality and productivity reviews of staff members and provides feedback on performance. The Manager also participates in the hiring and disciplining of staff members. This position is also responsible for organizing, scheduling, and supervising staff to ensure adequate coverage, as well as prompt responses to issues, concerns, and/or complaints.

The Manager is also responsible to maintain a working knowledge of functions throughout the billing department.

The Manager works closely with IS and the Rev Cycle Systems teams and vendors to ensure the highest level of technology is being utilized throughout the Epic billing Modules.

Connecticut Children's is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children's offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members.

At Connecticut Children's, treating children isn't just our job - it's our passion. As a leading children's health system experiencing steady growth, we're excited to expand our team with exceptional team members who share our vision of transforming children's health and well-being as one team.

EDUCATION and/or EXPERIENCE REQUIRED

Bachelor's degree in Healthcare Management or related field, or an Associate degree plus 3 to 5 years relevant experience required.

Experience working as a Supervisor or Lead preferred.

Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

• Knowledge of state and federal regulations as they pertain to billing processes and procedures
• Knowledge of insurance claim processing and third party reimbursement
• Knowledge and detailed understanding of all negotiated agreements
• Knowledge of the principles of Information Management in order to effectively analyze and make decisions
• Demonstrated leadership in establishing and achieving goals
• Ability to communicate effectively both orally and in writing, strong computer and math skills required
• Skill in problem solving in a variety of settings
• Skill in technical or professional accounting
• Skill in time management and project management
• Ability to work efficiently under pressure
• Ability to operate a computer and related applications
• Ability to apply appropriate supervisory, management and leadership techniques in an operational setting
• Ability to work independently and take initiative
• Ability to demonstrate a commitment to continuous learning and to operationalize that learning
• Ability to deal effectively with constant changes and be a change agent
• Ability to deal effectively with difficult people and/or difficult situations
• Ability to willingly accept responsibility and/or delegate responsibility
• Ability to set priorities and use good judgment for self and staff
• Ability to exercise independent judgment in unusual or stressful situations
• Ability to establish and maintain effective working relationships.
• Manage the daily operations of the Billing area of Patient Accounts, assuring policy and procedures are followed and the billing process is handled in a timely and professional manner
• Develop & maintain an up-to-date policy & procedure manual to properly guide staff
• Review and improve work procedures and performance so that the most productive and efficient methods are being used
• Establish controls and review mechanisms for every procedure to ensure that systems and procedures are being followed correctly
• Review a random sampling of insurance billings on a routine basis to ensure claims are billed correctly and sent to proper mailing addresses
• Monitor progress for each area on a daily basis, utilizing quantitative productivity reports and providing feedback to staff
• Work collaboratively with other Revenue Cycle Management to establish processes to ensure that all financial information required for successful billing and collections is obtained and verified
• Review, analyze, and interpret monthly management reports to make informed managerial decisions to increase productivity or resolve issues. In addition, must communicate recommendations or findings to Revenue Cycle Director
• Maintain a strong knowledge base of billing and reimbursement procedures of third party and private insurance payers, state and federal regulations and local regulations related to insurance and private collections
• Ensure optimal system capabilities by coordinating with vendors and IS, providing training, documentation system parameters, challenging systems and obtaining feedback from staff/users
• Manage and supervises professional level staff, providing direction and guidance to the same, creating a team environment through training, recognition/evaluation, and in-service education, which produces optimum work habits and job performance
• Contribute to the achievement of the Financial Department goals and objectives
• In conjunction with the Director, ensure continued efficiency, improvement through benchmark analysis, competition, surveys and other external reviews
• Meet with other department as necessary to inform and be informed of all activities that may be pertinent to the integrated success of the revenue cycle and the organization.
• Serve as primary link between staff and the Director of Revenue Cycle
• Develop specific objectives and performance standards for each area of responsibility
• Act as an internal consultant; resolving problems and providing billing expertise to other hospital department areas
• Review write-off listings, miscellaneous cash adjustments, and departmental expense vouchers and submits to director for approval
• Contribute to the success of the organization by participating in the organizational and customer service/employee relations action plan programs, keeping current on new developments within the organization, and by performing other duties as needed or assigned
• Contribute to the success of the organization by meeting organizational competency expectations, continuously learning, and by performing other duties as needed or assigned

SUPERVISORY RESPONSIBILITIES

Kronos, performance management, Q&A Audits

• Manage the daily operations of the Billing area of Patient Accounts, assuring policy and procedures are followed and the billing process is handled in a timely and professional manner
• Develop & maintain an up-to-date policy & procedure manual to properly guide staff
• Review and improve work procedures and performance so that the most productive and efficient methods are being used
• Establish controls and review mechanisms for every procedure to ensure that systems and procedures are being followed correctly
• Review a random sampling of insurance billings on a routine basis to ensure claims are billed correctly and sent to proper mailing addresses
• Monitor progress for each area on a daily basis, utilizing quantitative productivity reports and providing feedback to staff
• Work collaboratively with other Revenue Cycle Management to establish processes to ensure that all financial information required for successful billing and collections is obtained and verified
• Review, analyze, and interpret monthly management reports to make informed managerial decisions to increase productivity or resolve issues. In addition, must communicate recommendations or findings to Revenue Cycle Director
• Maintain a strong knowledge base of billing and reimbursement procedures of third party and private insurance payers, state and federal regulations and local regulations related to insurance and private collections
• Ensure optimal system capabilities by coordinating with vendors and IS, providing training, documentation system parameters, challenging systems and obtaining feedback from staff/users
• Manage and supervises professional level staff, providing direction and guidance to the same, creating a team environment through training, recognition/evaluation, and in-service education, which produces optimum work habits and job performance
• Contribute to the achievement of the Financial Department goals and objectives
• In conjunction with the Director, ensure continued efficiency, improvement through benchmark analysis, competition, surveys and other external reviews
• Meet with other department as necessary to inform and be informed of all activities that may be pertinent to the integrated success of the revenue cycle and the organization.
• Serve as primary link between staff and the Director of Revenue Cycle
• Develop specific objectives and performance standards for each area of responsibility
• Act as an internal consultant; resolving problems and providing billing expertise to other hospital department areas
• Review write-off listings, miscellaneous cash adjustments, and departmental expense vouchers and submits to director for approval
• Contribute to the success of the organization by participating in the organizational and customer service/employee relations action plan programs, keeping current on new developments within the organization, and by performing other duties as needed or assigned
• Contribute to the success of the organization by meeting organizational competency expectations, continuously learning, and by performing other duties as needed or assigned

SUPERVISORY RESPONSIBILITIES

Kronos, performance management, Q&A Audits