Log In
Sign Up
Job Discription
Summary: An independent physician practice with 8 physicians and 3 APPs, serving the Eastern Wisconsin for over 50 years is looking for an experienced clinic Billing Manager to lead a team of 10. Using established practices, this position will help keep the financial performance strong, while bringing industry knowledge and experience to the table. This position is a key member of the leadership team and will be relied upon to help collect, gather, analyze, and act on data in cooperation with other managers and physician partners.
Education and Experience: Bachelor’s or Master’s degree preferred, at least 8 years of medical billing, health insurance and administrative experience required. Experience in data mining and analysis helpful.
Personal and Professional Qualifications: Must be able to effectively provide direction and lead people. Must have ability to work with a high degree of speed and accuracy on multiple tasks and pay attention to detail. Possess good oral and written communication skills. Must be adept at researching patient record information in order to complete billing tasks as well as being knowledgeable regarding health insurances. Ability to work independently as well as with staff and physicians. Must be dependable with regard to attendance. Must have the ability to prioritize and organize work assignments. Must display a neat, clean, and professional appearance at all times. Adhere to strict patient confidentiality and all HIPAA regulations. Is a revenue cycle expert for the organization. Work with other leaders and staff of all levels in a friendly and engaged manner.
Essential Duties, Functions, and Responsibilities:
· Supervise and lead Billing Department staff, provide training/coaching as necessary, and determine work schedules and work responsibilities.
· Create/update procedural manual for the Billing Department.
· Monitor, confirm, and log all payments to clinic.
· Balance payments on a daily, weekly, monthly, and annual basis; and, generate payments reports for the Bookkeeper on a weekly, monthly, and annual basis.
· Monitor A/R and generate A/R reports to assign to staff for follow-up.
– Monitor payment averages from insurance companies and patients.
– Monitor electronic claims files to insure all are uploaded and received by claims clearinghouse and forwarded to payers.
· Work with team to achieve A/R key performance indicators.
· Resolve difficult patient billing and insurance issues by working with Billing staff, clearinghouse, and the electronic health record.
· Configure fees and establish CPT codes. Monitor reimbursement to insure that fees are set at the correct amount.
· On a daily basis review status reports from Billing staff of infusion claims generated, daily claims generated, and infusion schedules verified.
· Calculate Medicare’s allowable for infusion drugs. Update spreadsheet and review patient accounts for proper insurance reimbursements on a quarterly basis.
· Investigate and implement PQRS on an annual basis.
· Work with the Lab Manager to set up lab panels needed for billing purposes.
· Reverse collection write-offs in order to post payments received in house and from the collection agency. Review and update balances due when a payment is received on a collection account.
· Provide reports at the request of the physicians and/or Practice Administrator.
· Notify the Practice Administrator of any pending issues with serious consequences.
· Be able to effectively present information to physician partnership and administrator.
· Maintain knowledge of changes in the insurance/billing fields.
– Utilize industry experience and knowledge to increase efficiency, productivity, and metrics by which the organization can sustain the growth currently being experienced.
· Other duties as assigned.
Education and Experience: Bachelor’s or Master’s degree preferred, at least 8 years of medical billing, health insurance and administrative experience required. Experience in data mining and analysis helpful.
Personal and Professional Qualifications: Must be able to effectively provide direction and lead people. Must have ability to work with a high degree of speed and accuracy on multiple tasks and pay attention to detail. Possess good oral and written communication skills. Must be adept at researching patient record information in order to complete billing tasks as well as being knowledgeable regarding health insurances. Ability to work independently as well as with staff and physicians. Must be dependable with regard to attendance. Must have the ability to prioritize and organize work assignments. Must display a neat, clean, and professional appearance at all times. Adhere to strict patient confidentiality and all HIPAA regulations. Is a revenue cycle expert for the organization. Work with other leaders and staff of all levels in a friendly and engaged manner.
Essential Duties, Functions, and Responsibilities:
· Supervise and lead Billing Department staff, provide training/coaching as necessary, and determine work schedules and work responsibilities.
· Create/update procedural manual for the Billing Department.
· Monitor, confirm, and log all payments to clinic.
· Balance payments on a daily, weekly, monthly, and annual basis; and, generate payments reports for the Bookkeeper on a weekly, monthly, and annual basis.
· Monitor A/R and generate A/R reports to assign to staff for follow-up.
– Monitor payment averages from insurance companies and patients.
– Monitor electronic claims files to insure all are uploaded and received by claims clearinghouse and forwarded to payers.
· Work with team to achieve A/R key performance indicators.
· Resolve difficult patient billing and insurance issues by working with Billing staff, clearinghouse, and the electronic health record.
· Configure fees and establish CPT codes. Monitor reimbursement to insure that fees are set at the correct amount.
· On a daily basis review status reports from Billing staff of infusion claims generated, daily claims generated, and infusion schedules verified.
· Calculate Medicare’s allowable for infusion drugs. Update spreadsheet and review patient accounts for proper insurance reimbursements on a quarterly basis.
· Investigate and implement PQRS on an annual basis.
· Work with the Lab Manager to set up lab panels needed for billing purposes.
· Reverse collection write-offs in order to post payments received in house and from the collection agency. Review and update balances due when a payment is received on a collection account.
· Provide reports at the request of the physicians and/or Practice Administrator.
· Notify the Practice Administrator of any pending issues with serious consequences.
· Be able to effectively present information to physician partnership and administrator.
· Maintain knowledge of changes in the insurance/billing fields.
– Utilize industry experience and knowledge to increase efficiency, productivity, and metrics by which the organization can sustain the growth currently being experienced.
· Other duties as assigned.
