Medical Billing Manager

1 month ago


Harlingen, United States South Heart Clinic Full time
Job DescriptionJob Description
Position Overview:

South Heart Clinic, PLLC (SHC) is looking for a Medical Billing Manager to join our team
The Medical Billing Manager supervises the day-to-day revenue cycle operations in order to maximize the collection of medical services payments and reimbursements from patients, insurance carriers and guarantors. The Manager coordinates and ensures that all revenue cycle activities are completed effectively and efficiently, in a manner that consistently meets or exceeds expected outcomes.

The essential duties and responsibilities:
  • Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients' accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues.
  • Responsible for quality work, meeting deadlines, and adherence to the Practices Standard Operating Procedures; regularly audits staffs work to ensure compliance.
  • Monthly, prepares revenue cycle financial analysis, including aged accounts. Monitors and assesses business metrics in order to refine processes and improve Guides individuals and teams toward priorities; clarifies roles and responsibilities of others; coordinates resources to meet objectives.
  • Promotes new initiatives; acts as a catalyst of change and stimulates others to change; paves the way for needed changes; manages implementation effectively. Steps forward to address difficult issues; puts self on the line to deal with important problems; takes ownership and accountability.
  • Develops, implements, and maintains the Practice's revenue cycle training materials. Conducts training of systems, metrics, government regulations, and etc.
  • Responsible for the overall coordination of front office duties to include scheduling, check-in, and co-pay/co-insurance collection.
  • Attracts high caliber people, accurately assesses strengths and development needs of employees; provides timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline.
  • Other duties as requested or assigned.
Qualifications:

The ideal candidate for the position will have the following background and experience:
  • Bachelor’s degree in Finance, Business or equivalent or four years revenue cycle experience required.
  • At least four (4) years of medical revenue cycle work experience required with a consistent track record of achieving metrics.
  • Two-year experience managing, delegating, and following up on work priorities of others is strongly desired.
  • Individual must have strong knowledge of medical insurance billing and collections with CPT, ICD9, and HCPC coding and medical terminology, as well as an overall understanding of managed care products (HMO, PPO, etc).
  • Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint).

 

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