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Outpatient Clinic Billing Manager

3 months ago

Wisconsin Rapids, United States Opportunity Development Centers Inc Full time
Job DescriptionJob DescriptionSalary: Based on Experience

TITLE: Outpatient Clinic Billing Manager


Summary of Position

Provide Clinic and Business guidance between clinical and senior management team.  This position would combine clinical and business aspects of healthcare management to ensure clinic operation is efficient and provides high quality of care.  Responsible for monitoring and managing all daily billing activity for ODC’s Mental Health programming. This position would be responsible for preparing clean and timely claims submissions, resolution of unpaid/denied claims, posting of payments into patient accounts, maintaining precise data and obtaining/tracking payments. Will serve as the primary resource to staff and insurance companies for questions related to billing.


Education and Experience

Bachelor’s degree in accounting, finance, or related field preferred. A minimum of two years work experience in billing and insurance claim processing, preferably in a clinic setting, required. Experience with electronic billing a plus. This position requires pre-employment and annual background checks.


Knowledge, Skills and Abilities/Essential Functions

**Following is a listing of representative examples of duties for this position; it is not considered a complete listing of all duties and responsibilities for the position.

  • Day to Day management of multiple locations of Opportunity for Hope.
  • Generate and process accurate billing invoices for services.
  • Auditing clinical practices to ensure quality of program.
  • Assure staff scheduling and hiring for any open non-clinical positions.
  • Work in Collaboration with Mental Health Director to create and oversee budget and billing.
  • Understanding and credentialing clinicians in appropriate insurance contracts.
  • Understand professional obligations around patient care and delivery.
  • Verify accuracy of billing data, including service codes, session details and consumer information.
  • Collaborate with the clinic and community mental health teams to gather necessary billing information.
  • Responsible for insurance company contacts and prior auth confirmations.
  • Collect and complete all information for staff credentialing.
  • Prepare, submit, and monitor insurance claims for mental health services.
  • Responsible for assuring charges and payments are accurately posted and end of day balancing is complete daily.
  • Responsible for following up on authorizations and billing information with funders and insurance companies to ensure things are billed and paid promptly and correctly.
  • Assure patients understand their insurance and private pay responsibilities as it relates to their service.
  • Responsible for maintaining and managing mental health department billing/revenue reports.
  • Assist with tracking data pertaining to end of month/year reports, including cost of services.
  • Maintain organized and detailed records of billing transactions, client information and insurance correspondence.
  • Protect patient rights by maintaining confidentiality of personal and financial information.
  • Stay updated on insurance regulations, relevant laws and coding requirements relevant to ODC services.
  • Therapy Notes support for Mental Health Department – responsible for updates and training.
  • Ability to handle multiple duties in a fast-paced environment.
  • Investigate and resolve patient and staff issues.
  • Strong attention to detail and ability to meet deadlines.
  • Develop and implement strategies with the Mental Health Director to improve/expand services.
  • Effectively communicate with others – verbal and written.
  • Work independently to ensure consistency with ODC policies and procedures.
  • Utilize computer for word processing, excel and database software and experience with electronic medical records.
  • This position requires use of a company email address which requires an application to be downloaded on your personal cell phone for multi-factor authentication (MFA) to ensure cyber security.  

Physical Requirements

  • Ability to facilitate, initiate and respond to verbal, written, computerized, telephone and fax communication.
  • Ability to demonstrate, train and/or model job tasks/duties/responsibilities.
  • Mobility to access various locations within/outside ODC facilities.
  • Lifting 10-25 lbs occasionally.
  • Reliable vehicle (unless determined exempt with HR)  VP Finance & Administration

REPORTS TO: VP Finance & Administration