**Billing Operations Manager**

3 weeks ago

Pratt, Kansas, United States Pratt Regional Medical Center Full time

Job Summary:

The **Billing Operations Manager** at Pratt Regional Medical Center is responsible for overseeing the billing operations of the health center, establishing and maintaining billing policies and procedures, ensuring accurate and timely submission of claims, developing strategies to improve billing efficiency and accuracy, and maintaining compliance with all federal and state regulations.

Key Responsibilities:

  • Billing Operations:
    • Oversee the daily billing operations, ensuring timely and accurate billing processes.
    • Monitor the submission of claims to insurance companies.
    • Utilize Thrive and Trubridge to manage and streamline billing operations.
    • Create payment batches and daily deposit files.
    • Review and generate refunds promptly.
    • Review and approve account adjustments for Charity Care, Administrative Adjustments, and Negotiated Discounts.
    • Maintain administrative login to payer sites.
  • Team Management:
    • Serve as the primary liaison between Pratt Regional Medical Center and all external vendors for all patient account relating tasks.
    • Develop and implement training programs to ensure vendors are knowledgeable about billing procedures and regulatory changes.
    • Foster a collaborative and efficient work environment between Pratt Regional Medical Center and contracted staff.
  • Financial Management:
    • Monitor accounts receivable and implement strategies to reduce common delays with claim processing.
    • Prepare and analyze billing reports, identifies trends and areas for improvement.
    • Collaborate with financial management staff to develop and manage the billing department budget.
  • Compliance and Regulatory Management:
    • Ensure all billing activities comply with federal, state, and local regulations, including HIPAA.
    • Stay updated on changes in healthcare billing regulations and guidelines.
    • Conduct regular audits to ensure accuracy and compliance with Pratt Regional Medical Center billing policies and procedures.
    • Reconcile system balances in Thrive to external vendor balances in Silo, Care Payment and Trubridge.
  • Customer Service:
    • Forward patient billing inquiries and issues to Code Quick promptly to resolve.
    • Collaborate with other departments, ensures a seamless patient experience regarding billing and payments.

Qualifications:

  • Strong understanding of revenue cycle principles, with an emphasis on patient accounting and reconciliation.
  • Excellent communication and organizational skills.
  • Proficient in using billing software and Microsoft Office Suite.
  • Ability to analyze financial reports and data to make informed decisions.

Education/Experience:

  • A bachelor's degree in healthcare administration, business administration, accounting, or a health-related field is strongly preferred.
  • Minimum of 5 years of experience in healthcare.
  • Experience in a similar healthcare setting is desirable.

Computer Skills:

  • Proficiency in the use of billing software applications and general MS Office applications.
  • Experience with Thrive or Trubridge (preferred, not required).

Certificates and Licenses:

  • Certified Revenue Cycle Representative (CRCR) (preferred, not required).
  • Certified Medical Biller (preferred, but not required).

Work Environment:

  • The position is primarily office-based, with regular working hours.
  • Occasional travel may be required for training and conferences.

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