- Responsible for supervising of all activities of Billing/Revenue Department, including personnel supervision, account management and assigned projects, implementation of appropriate billing procedures, coding and insurance updates and implementing changes within the department. Ensure timely and accurate billing claim submissions to responsible third-party payers via our billing company or our Revenue Cycle Coordinators. Assure compliance with Medicare and Commercial Insurances, Federal and State Laws impacting health care. Monitor and perform edits to our electronic billing system to achieve high accuracy of clean claim ratios. Work closely with our Billing Company, Finance Department, and Executive Management to provide reports and updates of billing activities and collection results.
- Oversee day-to-day billing functions for our practice physicians.
- Audit and create reporting spreadsheets for physician accounts.
- Review accounts receivable on a regular basis.
- Oversee the review and resolution issues related to claim generations, clean claim ratios, rejected or denied claims.
- Review the accuracy of charge capture, missing charges, late charges, covered and non-covered charges billed by our billing company.
- Oversee the elevation issues with payers and report improvements as appropriate.
- Ensure appropriate and professional communication with payers, billing company Executive Management and patients.
- Review insurance updates and relay information to staff, billing company, and Executive Management.
- Maintain and update databases as needed and keep provider information correct and current.
- Provide Key Performance Indicator performances to Executive Management.
- Maintain and run reports on our analytics platform and translate results in excel reports.
- Manage and oversee Billing/Revenue Cycle and Front Desk Department staff and ensure absence coverage. Handle personnel matters as needed in conjunction with Chief Financial Officer and Human Resource Director.
- Schedule and conduct regular department meetings.
- Establish department policies and standard operating procedures as well as to implement quality and performance improvement measures for the department.
- Serve as a resource to the staff by answering questions, assisting with problems, and provide training as necessary.
- Occasionally attend related online seminars and billing workshops to enhance billing knowledge, update department on changes, especially HIPPA, electronic billing, Medicare and Commercial billing.
- Assist with credentialing of our physicians with health insurance companies and hospitals.
- Complete performance reviews for Revenue and Front Desk Department staff members.
- Support with other administrative duties as needed or any other duties as assigned by Executive Management.
- Possess 3 + years of managerial billing experience with strong knowledge of revenue management.
- Proficient in Microsoft Excel, Microsoft Word and Microsoft Outlook.
- Capability of researching discrepancies and provide problem resolution.
- Willingness to cross-train and automate, when necessary.
- Ability to work independently, effectively with other managers, staff, departments, as well as being able to accept direction.
- Ability to manage, direct, and delegate responsibility and authority to staff.
- Medical, dental, vision, 401K
- Paid sick / vacation time
- Paid holidays
Covid 19 precautions:
We have modified our offices and follow recommended state and CDC guidelines. Covid vaccination per RI Mandate.