|Company:||Virginia Garcia Memorial HC|
|Description:||Job Summary: The Billing Manager manages and oversees the Billing Group within the Finance Department. This position participates in the development and implementation of billing operating policies and procedures, and audits current procedures to monitor and to improve efficiency of billing operations. The Billing Manager oversees the hiring, supervision, and training of the billing staff.|
Essential Duties and Responsibilities:
Oversee management of the day-to-day operations of the Billing Group ensuring adherence to policies and procedures.
Oversee the hiring and supervision of personnel, which includes work allocation, training, and problem resolution; evaluate performance and make recommendations for personnel actions, including termination; motivate employees to achieve peak productivity and performance.
Work with Controller and/or CFO to establish departmental goals and timelines and update Controller and/or CFO monthly on whether the goals have been met; inform Controller and/or CFO as soon as possible if there are barriers to meeting goals.
Develop or assist Controller and/or CFO with the development and implementation of policies and procedures to ensure efficient and safe operation of the department and to meet established goals and timelines.
Work with the Controller and/or CFO and other staff in the planning, implementation and evaluation of modifications to existing operations, systems and procedures, especially those related to reimbursement maximization and collection of accounts receivable.
Monitor accounts receivable; respond as needed to accounts receivable problems.
Maintain the tables and information in the practice management system that supports patient and insurance billing. Keep current on updates to the practice management software and communicate changes to staff. As needed, work with practice management software vendor and clearinghouse to solve billing problems.
Oversee clinic’s collection programs. Monitor and evaluate program effectiveness and progress and work with Controller and/or CFO on improvements and changes. Act as the liaison with the collection agency, and monitor performance of the collection agency.
Coordinate with Controller and/or CFO on needed training for providers in coding and maximizing reimbursement.
Handle patient complaints about fees and billing and decide upon the disposition of these complaints.
Handle complaints and quality requirements relating to billing department function from insurance carriers and other third party payers and decide upon resolution strategies for these complaints.
Work as liaison with other departments, to facilitate problem solving and data collection appropriate to patient and insurance billing.
Ensure that all billing and collection activities meet and adhere to Medicare, Medicaid, and other insurance regulations, rules, and laws.
Participate in performance improvement projects as assigned.
Participate in meetings and committees as assigned.
Attend and participate in staff meetings and required education programs.
Attend and participate in management team meetings.
Follow clinic-wide and departmental policies and procedures.
Adhere to all applicable laws and regulations.
Maintain confidentiality within the workplace and within the community.
Perform other job duties as assigned by Controller and/or CFO.
Handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
The Billing Manager will have access to PHI in the course of his/her duties. The Billing Manager uses PHI for all aspects of billing, patient’s accounts and communications with insurance companies. Applying the minimum necessary standard of HIPAA, the designated record sets to which this employee will have access to: all information in the practice management system, the full medical record, end of day reports from the practice management system, encounter forms, all communications from insurance companies, all collections information.
Knowledge, Skills and Abilities:
Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.
Ability to use independent judgment and to manage and impart confidential information.
Knowledge and understanding of medical billing and/or coding systems, as appropriate to the position.
Knowledge of Federal, State, and payer regulations regarding medical billing compliance.
Knowledge of computerized information systems used in medical and dental billing.
Ability to effectively communicate information, policies, and/or procedures in a manner easily understood.
Commitment and alignment to Virginia Garcia’s mission, vision and values.
High degree of confidentiality, integrity and professionalism.
Ability to develop, plan, and implement short-and long-range goals.
Ability to foster a cooperative work environment.
Employee development and performance management skills.
Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, Outlook); working knowledge of EPIC preferred.
Ability to communicate effectively, both orally and written.
Bilingual in English/Spanish, both verbal and written, a plus.
Education and Experience:
Bachelor’s degree in Business Administration or equivalent relevant field required.
Coding Certificate preferred.
Three or more years of experience in staff supervision required, with prior training experience.
Experience in medical/behavioral health/dental billing (ICD-10 CPT and HCPCS) required.
EPIC software experience preferred.
FQHC/PPS/Capitation Billing experience preferred.
|Address:||3305 NE Aloclek Dr|
Hillsboro, OR 97124