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Senior Billing Operations Manager

2 months ago

Saginaw, Michigan, United States Spark Talent Inc Full time
Job Description

**Job Summary**

The Senior Billing Operations Manager will oversee the daily operational needs of Spark Talent Inc. This role will be responsible for managing client assignments and projects, delivering high-quality service, and coaching, advising, and supporting team members in meeting client and personal development expectations.

Key Responsibilities:

  • Oversee the operations of the billing department, including medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, collections, electronic files, and reimbursement management.
  • Assist in the development and implementation of procedures and policies for administering staff workflow and personnel activities.
  • Organize workflows, supervise day-to-day activities, and ensure that billing deadlines are met, and payments are maximized.
  • Educate and train staff, act as a professional subject matter expert, and mentor to staff.
  • Maintain a working knowledge of insurance carriers, payers, and processes utilized within the revenue cycle.
  • Oversee the prospective new client process.
  • Actively participate in planning, troubleshooting, and processing in various billing areas.
  • Analyze billing and claims for accuracy and completeness.
  • Audit current processes and procedures to monitor and improve efficiency of billing and collections operations.
  • Maintain and comply with all HIPAA guidelines and regulations.

Qualifications:

  • Associate's degree in a related field or equivalent work experience.
  • Minimum of three (3) years' experience in a medical billing, coding, healthcare, or related industry.
  • Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
  • Working knowledge of CPT codes, ICD-10-CM codes, HCPCS codes, HIPAA, and HCFA 1500.

Desired Qualifications:

  • Prefer certification as a Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA).

Knowledge, Skills, and Abilities:

  • Knowledge of the current and future state of the healthcare industry.
  • Skill in problem-solving and the ability to deal with employee issues.
  • Ability to work under stressful situations.
  • Ability to adapt to an ever-changing business environment, including healthcare policies and procedures.
  • Ability to lead and guide the work of others.
  • Ability to investigate and analyze information and to draw conclusions.
  • Ability to communicate efficiently and effectively both verbally and in writing.
  • Ability to handle multiple tasks and meet deadlines.

Business Development:

  • Manage client accounts to ensure customer service needs are being met.
  • Expand sales within existing accounts.

Leadership:

  • Reports to the President of Spark Talent Inc.
  • Supervise medical billing staff, overseeing both personnel and work activities.
  • Evaluate the performance of medical billing staff annually.
  • Provide guidance and support in career development opportunities for staff, including training opportunities and feedback.
  • Establish and maintain sound working relationships with peers, supervisors, and clients.
  • Review employee timesheet details and report weekly on employee technical accuracy.
  • Work with the Talent Manager to recruit, develop, and retain high-performing employees.

Technology:

  • Coordinate with vendors to ensure seamless implementation and continual maintenance of systems.
  • Train, implement, and oversee software used within the organization, including clearinghouse software, medical billing software, and data management workflow software.

Physical Demand:

  • Frequent use of hands, wrists, fingers associated with computer equipment.
  • Required to sit for extended periods of time.
  • Occasionally stoop, kneel, crouch, or crawl.
  • Normal visual acuity, ability to talk, and hear.
  • Occasionally lift and/or move up to 20 pounds.

Working Conditions:

  • On-site position.
  • Normal office environment.
  • May on occasion be exposed to loud sounds and distracting noise levels, such as from office equipment.