Manager of Medical Billing/Accounts Receivable Position Available In South Central Connecticut Planning Region, Connecticut

Manager of Medical Billing/Accounts Receivable The Children s Center of Hamden Inc Hamden, CT Job Details Full-time $60,000 – $70,000 a year 9 hours ago Qualifications Heavy lifting 5 years Medical coding Windows Outpatient SQL Supervising experience Bachelor’s degree Medical billing Medical Billing & Coding Medical Billing Certification Senior level Full Job Description Manager of Medical Billing/Accounts Receivable

POSITION SUMMARY

The Manager of Medical Billing manages all functions of the organization’s billing and revenue cycle and develops effective workflows to maximize cash flow while maintaining and improving internal and external customer relations. In oversight of the billing team, the Manager will contribute to the day-to-day operations on all issues related to the medical billing function, provide analysis, create written processes, and train others in implementing a cross functional medical billing team. This position will also provide primary support and data integrity to ensure stable operation of the EHR system. Provide an effective primary point of contact for EHR related problems and questions; aids, supports and provides guidance to equip staff to better do their jobs utilizing EHR resources. Includes planning, developing, installing, configuring, maintaining, supporting, and optimizing activities related to the Agencies EHR. The Purpose of this position is to direct and coordinate the department responsible for all medical municipal and contract billing and A/R collections of the Agency. Has strong knowledge and skill set with A/R functions to ensure all A/R activities are done timely and accurately to guarantee proper month end close.

TECHNOLOGIES

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EHR, SQL

Database, MS Windows Supervisory Responsibilities Manages and oversees employees in outpatient billing, managed care, and credentialing departments. Carries out supervisory responsibilities in accordance with organization policies and applicable laws; including interviewing, hiring, and training employees; planning assigning and directing work; appraising performance, rewarding, mentoring, coaching and disciplining employees; addressing complaints and resolving problems. Accountable and responsible for the following

Duties and Responsibilities:

Coordinates and oversees billing activities with billing department staff to ensure all services billed have been authorized and client eligibility verified, as appropriate. Lead the day-to-day operations and output of the Outpatient Billing Department; monitor workflow, quality, productivity; administer Dept. policies & procedures; collaborate externally & internally; resolve obstacles & challenges; provide for records and systems mgmt., and any/all related other activities. Maintains and updates billing software application for contract rates, service codes, payer files, staff files and agency programs. Identifies the work with IT staff and program directors to implement changes driven by external requirements (for example: DCF, DSS, HPS or CMS-Medicaid) Identifies service-related financial loss refunds and write-offs of all outpatient services, which involves verifying overpayments and approving reimbursement to indicated parities; approving EOB reconciliation write-offs after confirming justification for service rendered and similar duties. Develops and implements systems, tools, reports, and policies for patient revenue management. Stays informed on all Patient Account, Insurance and Eligibility program matters pertaining to the Agency and recommends appropriate action to maximize funding and maintain compliance with all regulations. Communicates changes in regulatory requirements, reimbursement, and coding to staff. Establishes and fosters active working relationship with payer sources to have first-hand knowledge of the most recent developments and trends in claims processing and covered services. Oversees Managed Care credentialing for all providers. Manages relationships with and acts as liaison to managed care companies, insurance companies, other payor sources and any/all internal and external parties to accomplish goals and objectives of department efficiently and effectively, as well as trouble shoot where needed. Provides primary support and data integrity to ensure stable operation of the EHR system and serves as primary point of contact for EHR related training and trouble-shooting aids, supports, trains, and troubleshoots to equip staff to better do their jobs utilizing EHR resources. Helps maximize the agency’s cash flow through effective management of the agency’s accounts receivable process, specifically, Prepares and submits all claims and invoices to payers in accordance with payer requirements and established billing deadlines. Prepares and mails monthly statements of self-pay accounts. Applies payer remittances to accounts in a timely manner. Identifies discrepancies between amounts billed and paid. Pursues collection of overdue accounts and amounts denied or paid inaccurately. Advises the agency’s CFO and Controller of payer issues that may require escalation to achieve successful collection of outstanding amounts. Monitors the accounts receivable aging for services, including investigating and responding to any unfavorable trends identified. Perform financial payment related bookkeeping entries and activities to ensure maximum payment is received for services and accounted for accurately, which include posting payments for deposit; transferring payment to secondary insurer; approving adjustments and allocating grant funds, maintaining & updating service fee schedules; and related similar duties. Supports financial reporting with month end closing of billing system, including: Monthly journal entries of revenues billed, collected, and adjusted. Aging of accounts receivable by payer. Cash receipts summary Ensures operations meet department policy and standards of practice, and partake in as needed daily billing, and collections, such as, patient and insurance account aging and claim denials; client assistance with financial payments and customer service; collection referrals and recommendations; internal & external management and financial reporting and all related other. Review of outstanding receivables with CFO and/or designee to assess adequacy of the allowance for doubtful accounts. Has experience working with Carelogic. Perform other duties as assigned.

MINIMUM 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. Bachelor’s degree required, medical billing and coding certification preferred. A minimum of five years directly related experience in outpatient billing with at least two years at a supervisory level. Demonstrated ability to manage a high volume of activity and achieve outstanding collection results Demonstrated proficiency with Medical Billing and Coding Reporting, Accounts Receivable, Networking, SQL, EHR Administration, EHR Development and EHR Application Support needed.

LICENSURE / CERTIFICATIONS PHYSICAL REQUIREMENTS / WORK ENVIRONMENT

While performing the duties of this job, the employee is regularly required to perform the following essential job functions: Light lifting ( 50 lbs) Bending Climbing Talking Driving Repetitive Motion Push/Pulling Other, specify: The work environment is primarily representative of those an employee encounters while performing the essential functions of the job. Potential exposure to waste and bodily fluids Potential allergenic and/or irritant conditions Retail store may have fluctuating temperatures in donation area

CORE COMPETENCIES

Behaviors and skills employees are expected to demonstrate to carry out the mission and goals.

Values/Ethics:

Ability to act with integrity and respect in personal and organizational practices, treating all people equitably including respecting professional, ethical and people values.

Communication:

Ability to write and speak clearly and succinctly in a variety of communication settings; can get messages across that have the desired effect.

Conflict Resolution:

Facilitating the prevention and/or resolution of conflict while preserving working relationships while maintaining composure.

Organization:

Ability to manage multiple projects; determine project urgency, uses goals to guide actions; organizes and schedules task effectively.

Team work:

Readily sharing information, knowledge and personal strengths. Seek to understand and build on differing perspectives of others to enhance team efficiency and quality outcomes.

Computer:

Ability to use computers and other forms of technology. Ability to learn required office software products.

Decision Making/Decisiveness:

Making and taking responsibility for, and demonstrating commitment to appropriate decisions in a timely manner. Ensuring that decisions are made based on policies, rules and organizational directives and solving the emerging problems.

Leadership:

Creating a working environment that promotes and encourages team members’ participation to attain common and individual objectives. Leading by example.

Project Management:

The discipline of planning, organizing, and managing resources to bring about the successful completion of a specific project.

Strategic Thinking:

Innovating through analysis of issues and trends and how these link to responsibilities, capabilities and potential of the organization. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.