Business Office Manager
4 weeks ago
Purpose of Your Position
Responsible for all processes of outpatient registration, insurance verification, and authorizations for medical and rehabilitative services. Supervise Registrar and front desk personnel.
Job Functions
Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.
Position Functions and Responsibilities
Daily review and submission of encounters/claims to insurance carriers; while addressing any issues that may arise.
Import Medicaid files, enter all explanation of benefit information and payments from carriers and other payors timely
Monitor and resolve all claim rejections for re-submission
Obtain and/or provide medical records, therapy notes and insurance authorizations to be provided to insurance carriers when requested.
Review accuracy of all incoming payments and explanation of benefits from Insurance carriers and self-pay payments. Identify further collection and/or submission to secondary carrier as required; accept assignment when no other payor is available. Provide documentation to the clerks for posting, and to Controller for monthly reconciliation.
Review accounts for credits and process refunds if needed.
Daily reconciliation of encounters to appointment schedule.
Daily statistical reporting and monthly unitization reports provided to Management and Controller
Provide monthly aging report to the Director of Finance and Manager of Patient Accounts review all outstanding collection issues
Reviews medical orders and authorizations to verify that billing is consistent with order; if not consult with provider
Scan and deposit checks as needed, ensuring that checks are deposited before month end
Train billing staff for coverage and to ensure future succession planning
Create and periodically update Billing Department manual to include all aspects of the department duties and instructions of how billing is done via the system
Chart carrier payments made directly to patients, and on a monthly basis send invoices to guarantor for collection of outstanding portion of receivable.
Communicate with responsible party if change of insurance occurs and/or when authorization renewals are needed
Comply with established Organizational policies and procedures
Participate in all departmental in-services, meetings, and staff development activities
Qualifications:
Education Requirements:
High school graduate.
Experience:
Experience in Clinical billing, and familiarity with diagnostic interpretation and coding.
Good organizational skills, computer and telephone skills.
Supervisory experience.
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