Professional Billing Manager

Summary

Accountable for managing various aspects of billing operations and outstanding accounts receivable. Manager is responsible for developing and implementing long-range work plans, resource and workflow management, and is accountable for effectively managing costs within their respective work areas. The Manager will be required to assume management and leadership responsibilities for daily operations of their assigned work units.

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis. Any other duties as needed to drive to the vision fulfill the mission and abide by the values of the organization.

These duties and responsibilities described below represent the general tasks performed daily. Other duties will be assigned as needed to ensure fulfillment of the organization’s goals, mission, and values.

• Manage the activities of employees and vendors to ensure adherence to CRMC standards

• Consistently monitor and track staff productivity and quality to collect cash and bring Accounts Receivables to full resolution

• Provide continued education to staff with regards to healthcare reform, payer updates, and system upgrades

• Work collaboratively with Revenue Cycle peers such as Care Management, Executive Leadership, HIM, Finance, Patient Access, or others within CRMC to meet departmental goals and objectives

• Review, monitor, and validate staff or vendor-initiated adjustments for certain dollar thresholds

• Collaborate with Patient Accounting leadership to assign goals for Patient Accounting

• Consistently review Epic work queues to ensure accounts are being worked optimally for the best AR results possible

• Conduct frequent quality reviews of staff output and overall workflow to ensure optimal work processes are in place to maximize revenue and reduce denials

• Month End Reporting to capture and consolidate issues and trends recording for Finance

• Monitor daily volumes and statistics for incoming phone calls, website usage and system notes

• Monitor and maintain strict compliance with Medicare and Medicaid Quarterly Credit Balance Reporting

• Maintain professionalism in all interactions with both internal and external customers

• Resolve patient complaints, vendor relations, charging issues, and interdepartmental concerns in a timely and professional manner

• Oversee the training and orientation of all new employees and vendors within the department

• Maintain current knowledge and awareness of changes with regulatory and payor processes, trends, and updates

Supervisory Responsibilities

Reports to:
Director, Patient Financial Services — may also be assigned work from the Chief Financial Officer (CFO)

Supervises:
An estimated 20 employees, including team leads, patient account representatives, senior patient account representatives, customer service representatives, and credit balance representatives

Responsibilities:
Manage the daily activity of Insurance Account follow-up, denials, and customer service

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience

Minimum Required Education:

Bachelor’s degree in Business, Healthcare Administration, or related field. Professional certification required within 1 year of start date in position.

Experience:

Three years of Revenue Cycle Management experience in a Health Care Setting required. Five years of revenue experience required in lieu of Bachelor's degree.