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Billing Operations Manager

2 months ago

Grand Forks, North Dakota, United States InsideHigherEd Full time
Compensation/Job Classification
  • $70,000 Annual, Based on Experience, Non-Exempt (Eligible for overtime)
  • 40 hours per week
  • Remote Work Availability: No
  • Hybrid Work Availability: No
Position Overview

The Billing Operations Manager oversees the daily activities of billing departments, ensuring that accurate coding and billing practices are upheld across the organization. This role is crucial in guaranteeing that insurance claims are correctly coded and submitted promptly, thereby maintaining the integrity of accounts receivable.

Key Responsibilities
  • Billing Operations Management
    • Assist in establishing daily operations and standardizing processes within the billing team.
    • Provide ongoing support and direction to team members, addressing issues related to accounts receivable and billing.
    • Generate and analyze financial reports from the billing system.
    • Supervise the reconciliation of daily deposits and electronic funds transfers.
    • Conduct annual performance evaluations for billing department personnel.
    • Support the recruitment process for new billing staff.
    • Facilitate training for medical residents in coding and billing practices.
    • Instruct both new and existing staff on proper procedures and billing systems, as well as organizational policies.
    • Address concerns and complaints from billing staff, or assist management in resolving issues.
    • Foster positive relationships with internal and external stakeholders to clarify policies and financial processes, enhancing timely reimbursement.
    • Deliver customer service for billing inquiries in person, via phone, or through written communication, ensuring compliance with regulations.
    • Provide welcoming reception assistance to patients and staff, promoting satisfaction and representing the organization positively.
  • Revenue Cycle Management
    • Maintain a comprehensive log of billing and payment activities for organizational accounts.
    • Submit medical insurance claims to third-party payers.
    • Monitor and collect accounts receivable, reporting delinquent accounts for necessary action.
    • Assist patients with inquiries regarding their insurance claims.
    • Evaluate accounts receivable to identify discrepancies and determine resolution strategies.
    • Oversee and analyze work queues to rectify errors, ensuring claims are ready for processing.
    • Process refunds for overpayments to patients and insurance accounts.
    • Record insurance and private payments accurately in the database.
    • Gather insurance information from patients and ensure accurate data entry.
    • Establish and maintain positive relationships with stakeholders to facilitate problem-solving and clarify financial processes.
    • Provide billing customer service through thorough analysis and research of patient accounts.
    • Ensure prompt and professional phone responses in line with organizational standards.
    • Review patient records to verify diagnoses and procedure codes submitted by providers.
    • Utilize coding principles and guidelines to ensure maximum reimbursement for clinic and inpatient visits.
    • Assist physicians in understanding proper coding guidelines to ensure compliance.
    • Code and enter charge information into the database, process electronic claims submissions, and review denials for appropriate follow-up.
Essential Qualifications
  • Advanced knowledge of revenue cycle management, including billing, coding, payments, and insurance claims.
  • Current knowledge of CPT, HCPCS, and ICD-10-CM coding standards.
  • Familiarity with insurance payer coding and reimbursement guidelines.
  • Experience in health information system management, including billing and medical record applications.
  • Ability to build and maintain effective working relationships with diverse parties.
  • Strong interpersonal skills, attention to detail, and ability to manage multiple projects simultaneously.
  • Demonstrated critical thinking skills and ethical decision-making.
  • Ability to handle patient inquiries with professionalism and efficiency.
  • Proficient in identifying, evaluating, and resolving issues and correcting errors.
Minimum Qualifications
  • Two years of college education in accounting, business administration, health information management, or a related field.
  • Five years of experience in a medical billing office with a focus on billing and insurance processing.
  • Three years of supervisory experience.
  • Certified Professional Coder (CPC) certification.
  • Experience with data entry and Microsoft Office applications, including Word and Excel.
  • Familiarity with electronic records systems, particularly the billing components.
  • Successful completion of a background check.

In accordance with federal regulations, all hires must verify their identity and eligibility to work in the U.S. and complete the necessary employment eligibility verification form upon hire. This position does not support visa sponsorship for continued employment.

Preferred Qualifications
  • Eight or more years of experience in medical billing.
Application Process

To ensure full consideration, all application materials must be submitted by the specified deadline.