Billing Manager

2 weeks ago

Houston, United States IPR Healthcare System Full time

IPR HealthCare System, Inc. is a leading and established Home Health & Hospice Care provider in Houston and the surrounding areas, providing a range of services including skilled nursing and rehabilitation care for over 20 years.

Our agency is known for long years of satisfied team members and family orientated atmosphere. We offer competitive salary and unique opportunities to grow within the company. Come be a part of IPR HealthCare System, Inc. with a high satisfaction rate, top quality of patient care star rating and a steady growing company.

**Responsibilities**:

- Follows department procedures to perform billing functions in a timely manner for the following programs:
Medicare Home Health

Medicare Hospice

Medicaid Home Health

Medicaid Hospice

Commercial Insurance

Other Contracts
- Reviews designated documentation for comparison of billing and appropriate documentation to ensure that all claims are accurate and submitted hourly.
- Verifies and resolves any discrepancy.
- Oversees billing staff responsibilities.
- Oversees verification of patient eligibility and oversees a medical record number assignment.
- Communicates with Medicare, Medicaid and Commercial Insurance companies and other contractors on billing issues.
- Coordinates the submission of billing requirements with the clinical department in a timely manner.
- Submits final billing within required time frame and monitors the status of all outstanding billed claims.
- Oversees all claims for each billing cycle.
- Oversees transmission of all claims.
- Post all claims to designated ledger for each billing cycle.
- Utilizing Remittance Advices or Similar Documentation, post all payments to designated ledger.
- Informs immediate supervisor of problems related to Billing and/or receipt of monies as soon as collection problem is identified.
- Follows up on claims status as frequently as necessary and documents utilizing the appropriate form. Utilizing **DDE, **or similar portal.
- Monitors denial patterns and ensures that proper appeal processes are implemented and managed on a timely basis; Follows up with billing deficiencies and assures timely correction; maintains contact with appropriate intermediaries regarding billing claims.
- Transmits OASIS information in a timely manner and distributes OASIS results to Administrator and Clinical staff.
- Submits a monthly report to Administrator re: Total Number of Claims submitted by payor source, total amount of monies received by payor source, total number of outstanding claims by payor source and state reason.
- Always maintains confidentiality of billing and clients and does not discuss client claims, organization financial information, o any type of financial information that he/she may be privy to with anyone other than immediate supervisor and designated executive office personnel.
- Works with the Medical Records Department and/or Payroll to resolve any discrepancies in billing.
- Coordinates billing discrepancy, ADR, RTP to the DON for immediate attention.
- Maintains all billing records per patient.
- Works with the medical records department and/or payroll to resolve any discrepancies in billing. Supervises subordinates as required for billing and filing.
- Coordinates with case managers to complete documentation of patient chart prior to billing
- Coordinates with hardware and software vendor to guarantee the compatibility of the home health computer system with TDHS & RI.
- Performs additional task (s) as directed.

**Qualifications**:

- High School or equivalent
- 2 years of college education (preferred)
- 2 years of medical billing/collecting experience with Medicare, Medicaid and commercial payors
- Reimbursement System
- Working knowledge of Lewis Prompt Operation
- Spreadsheet calculation experience preferred
- Excellent written and oral communication
- Ability to interact with senior executives, management and support staff
- Highly self-motivated, attentive to details, self-starter, result-oriented, excellent in time-management
- Knowledge of Microsoft Office
- Spanish Bilingual is a Plus

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift
- Monday to Friday

Work Location: In person

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