Job description
The Independent Physician Association of Nassau/Suffolk Counties, Inc., “IPANS”, was founded in 2011 when the need to support and preserve the independent physician was identified.
IPANS is one of the fastest growing and largest multi-specialty Independent Physician Associations in the country and has a physician membership base of over 2,500 independent physicians. IPANS is a non-exclusive, not-for-profit physician-led IPA focused on helping independent physicians remain independent, while staying on the frontline of healthcare.
IPANS is managed by Practice Management of America, Inc. (“PMA”) a managed service organization, (“MSO”), that specializes in payor negotiation and collaboration, full management of physician practices, billing and collections, clinical care management, group malpractice savings, human resources, payroll, group purchasing benefits and much more.
Our goal is to improve the quality of healthcare to ensure patients receive the Right Care, at the Right Place, at the Right Time ®
Job Description
This position is a “working” Billing Manager, while this position will be responsible for leading, planning and developing, it also requires a hands-on working approach with the team. This role will be dynamic in the fact that you will oversee an experienced billing team responsible for the billing of multiple practices in the IPA. This role has the opportunity for a tremendous amount of professional growth. This is an exciting opportunity for a forward-thinking individual that can work independently and has that ability to multi-task and complete work assignments timely and accurately. A highly visible position requiring a strong leader with the ability to prioritize, plan, and direct the department while meeting deadlines. This position reports to the Director of Billing & Credentialing.
Job Duties:
· Oversee the billing and collections and will be accountable for hitting weekly and monthly goals set by the Director of Billing
· Month-end closing, presentation of reports
· Plan and implement quality assurance for all processes
· Strong leadership skills with an ability to motivate
· Prepare, review, and transmit claims using eClinicalWorks and Kareo EMR systems
· Knowledge of clearinghouses, EDI setup, ERA Enrollment, statement submission and denial management through Trizetto and Waystar
· Scrubbing claims for accuracy, identifying opportunity for physician / staff and educating to ensure information is accurate to bill a clean claim, ability to communicate such opportunities to staff, providers, and upper management
· Validating reimbursement rates are accurate based on individual, group, and IPA contracts
· Acts as liaison between practice and Operational staff at the IPA
· Ensures total compliance with government and commercial payor regulations
· Manages a team both remotely and onsite, ensuring all goals and milestones have been met weekly, monthly, and quarterly
· Leads a team with positivity and motivation, responsible for training and educating staff on new policies and regulations set forth by Company and payors
· Call insurance companies regarding any discrepancy in payments
· Identify and bill secondary or tertiary insurances
· Patient Pay Responsibility follow-up required
· Denial Claims Management review, investigation and resolution required
· Strong knowledge of Quality Measures, HEDIS coding, and MIPS reporting
· Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
· Set up patient payment plans and work collection accounts
· Review patient bills for accuracy and completeness and obtain any missing information
· Hold biweekly meetings with Providers, discussing the current status of their account, detailing trends in payments, denials, and total AR
· The individual is responsible for enforcing policies and procedures as developed by the Director of Billing & Credentialing
Education/Experience and Skill Set requirements
· High School Diploma / College Degree preferred
· Minimum of 5 years of experience in a Medical Billing Management
· Certified Professional Coder certification (CPC, CPC-H, CCS, or CCS-P) a bonus!
· Extensive knowledge of ICD-10-CM coding conventions, official coding guidelines
· Proficient in all Microsoft products, specifically Excel, Outlook, Word, and PowerPoint a MUST!
· Excellent communication skills, both verbal and written
· Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
· Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
· Knowledge of medical terminology likely to be encountered in medical claims
· Proven ability to perform strategic planning and priority setting for a billing department
· Proven track record for improving process efficiencies and solving problems
· Job responsibilities can/may/will change as the role evolves and the vision expands.
Compensation: Salary / Benefits dependent upon experience. References a requirement.
Job Type: Full-time
Pay: From $27.00 per hour
Job Type: Full-time
Pay: From $27.00 per hour
Benefits:
Schedule:
Experience:
Work Location: One location
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