Job Summary: 

The Billing and Collections Manager will oversee all aspects of the billing and collections process, ensuring the timely and accurate production of claims, billing, follow-up, collections, cash receipts/adjustments, and compliance with third-party payer regulations. This role requires a comprehensive understanding of revenue cycle operations, and the manager will supervise the daily operations of the Billing & Collections Department. They will identify and address issues in the billing/collections flow and provide trends and reports to management. The manager will also be responsible for improving the efficiency of billing processes, troubleshooting issues, and ensuring the team's productivity. Additionally, the manager will be responsible for analytics and running reports to track key performance indicators, identify trends, and present actionable insights to management. The position also entails staff development and the execution of disciplinary actions in accordance with company policies.

Job Duties and Responsibilities:

• Oversee the billing and collections process, ensuring the resolution of complex, outstanding claims.
• Stay current on billing systems, government payer systems, and all relevant federal/state laws and regulations, as well as third-party payer reimbursement policies.
• Manage the day-to-day operations of the Billing & Collections Department, including planning, monitoring, and evaluating department functions to meet performance goals.
• Provide leadership and direction to the billing and collections team to ensure accurate and timely billing of accounts.
• Supervise the month-end close process, including the preparation and analysis of month-end revenue and A/R reports for the Executive Team.
• Lead, supervise, train, and motivate the team, ensuring professional conduct in interactions with management, staff, and third-party insurers.
• Identify opportunities to improve operational efficiency, optimize reimbursement, and monitor and report on denial trends.
• Run regular reports and analyze billing and collections data to track performance metrics, identify trends, and provide actionable insights to management.
• Demonstrate strong leadership, sound judgment in handling difficult situations, and excellent organizational, time management, and conflict resolution skills.
• Ensure the confidentiality of patient information at all times.
• Develop and implement quality assurance measures for billing and collections processes, including audits and identifying emerging trends and issues.
• Perform additional duties as assigned.

Qualifications and Experience:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are reflective of the knowledge, skill, and/or ability required.

• Graduate of a medical billing program.
• 2-3 years of experience as a Billing and Collections Supervisor.
• Proficiency in ICD-9/10 coding for Otolaryngology, Allergy, Dental, and Facial Plastic Surgery.
• In-depth knowledge of electronic billing systems, preferably Advanced MD.
• Familiarity with medical billing concepts, terminology, and the relationship between procedure and diagnosis codes to maximize reimbursement.
• Strong communication skills with patients, physicians, and staff.
• Excellent organizational, interpersonal, and decision-making abilities.
• Solid customer service skills, with the ability to manage conflict and collaborate effectively with employees, patients, physicians' offices, third-party payers, attorneys, etc.
• Ability to work autonomously with a high degree of accuracy and attention to detail.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Individual will be required to:

• Sit for long periods at a time
• Use hands and fingers in repetitive motions, daily
• Ability to lift, push, pull up to 10 lbs. periodically
• Travel to clinic locations or sites as needed
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions