Insurance Billing Manager
3 days ago
The Third-Party Billing Manager is responsible for preparing, submitting, and managing insurance claims to Medicare and commercial insurers, ensuring accurate and timely reimbursement for healthcare services. This position also manages the accounts receivable function for Duncaster.
Key Responsibilities- Verify patient insurance coverage and eligibility before billing.
- Prepare and submit clean claims to Medicare and commercial insurance payors, ensuring all necessary documentation is included.
- Maintain current, comprehensive working knowledge of payer contracts and ensure that payors are billed according to contract provisions.
- Monitor and follow up on unpaid or denied claims, working with Medicare and commercial insurers to resolve issues.
- Reconcile accounts and manage accounts receivable aging reports.
- Post payments and adjustments to patient accounts accurately.
- Reconcile Medicare quarterly reports produced by the fiscal intermediary with the billing information system and prepare the quarterly CMS 838 (Credit Balance) form.
- Collaborate with Senior Leadership to provide timely insight and communication regarding revenue and cash flow, and support operational initiatives as needed.
- Review and analyze denied claims, determining the cause of denial.
- Prepare and submit appeal letters and supporting documentation to Medicare and commercial insurers.
- Track the status of appeals and work to resolve them promptly.
- Associate's degree in accounting, business administration, or related field is required, bachelor's degree is preferred.
- Three years of progressively responsible experience in healthcare billing and collections management, preferably facility-based operations.
- Electronic Health Record billing systems knowledge is required.
- Must be able to speak, read, and write the English language in an understandable manner.
- Must have a strong working knowledge of Microsoft Office applications (e.g., Word, Excel, Outlook, PowerPoint).
- Demonstrated prior experience working well with others by contributing to the team cohesiveness.
- Ability to perform work accurately and thoroughly and comprehend complex technical topics and specialized information related to the accounting function.
- Ability to use thinking and reasoning to find a solution for or to deal proactively with work-related problems with the objective of making decisions or taking actions to solve a problem or reach a goal.
- Ability to recognize and organize the parts of an issue in a systematic way; and to frame new ideas and courses of action.
- 401(k) with match and profit sharing.
- Medical, dental, and vision insurance available the 1st of the month after hire.
- Short-term and long-term disability.
- Employee assistance program.
- Paid time off.
- Tuition reimbursement.
- 10% tuition discount on all degree and certificate programs at Charter Oak.
- Free Access to our Aquatic & Fitness Center & to our beautiful walking trails throughout our campus.
- Discount employee lunches.
- Duncaster Spotlight Employee Recognition Program.
- Referral bonuses.
- Free parking.
- Shoes for Crews - discounted safety shoes for all staff.
- Yearly performance increases plus additional bonus opportunities.
- Employee Appreciation Events held throughout the year by our own 'Funcaster' Committee.
- Ability to focus on task needs and perform intellectual executive functions as related to the functions of the business operation.
- Ability to execute intellectual tasks and duties under conditions of high demand and distraction.
- Ability to complete the essential functions of the position with or with adaptive personal devices (e.g., hearing aid, corrective lenses).
- Ability to operate equipment and technology required for the position.
- Must be able to communicate effectively.
- Able to assist with the evacuation of residents under emergency status to the best of their physical ability.
- Able to function independently with integrity and work effectively with residents, personnel, and support agencies.
- Able to move intermittently throughout the workday.
- Able to occasionally push and/or pull a force of up to 7 pounds as relates to file cart.
- Able to reach overhead, bend, and occasionally carry or lift up to 25 pounds.
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