Since 1969, OCR has been local and physician-owned with strong ties to the community. With a talented, hardworking and friendly staff, we all work toward the common goal of serving the residents of CO, WY, and NE with specialty-focused care. We are experiencing tremendous growth and are looking to add talented people to our team in all of our locations!
The Billing Manager is responsible for planning and directing the work of the billing department including monitoring daily workflow of staff, supervision of staff, conducting trainings, and ensuring complete compliance with all insurance carrier rules and regulations. This position works closely with the Director of Revenue Cycle and Payer Relations and Chief Financial Officer (CFO).
To perform this job successfully, an individual must have the knowledge, skills, and abilities identified below and be able to perform each essential duty and responsibility satisfactorily, either with or without a reasonable accommodation. The below is intended to describe the general content of and requirements for the performance of this job and is not to be construed as an exhaustive statement of essential functions, responsibilities or requirements.
Essential Duties and Responsibilities
- Directly supervises one or more employees. Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Addresses disagreements with staff to ensure a positive work environment. Works closely with HR on personnel issues. Reports critical personnel issues (e.g., disciplinary actions and/or termination) to supervisor.
- Ensures proper staffing and compensation levels are maintained within the billing team. Responsible for employee interviewing, termination and evaluation processes including recommending disciplinary action to supervisor.
- Responsible for planning and directing the work of the billing team including monitoring the daily workflow of the billing staff, oversight on daily billing process ensuring accurate and timely submission of claims, posting of receipts, allocation of unapplied payments, processing of refunds, etc.
- Conducts meetings with billing staff routinely to address issues, protocols, industry changes, department updates, goals, etc.
- Participates in training program for check-out staff ensuring proper accounting procedures are established and followed.
- Assists staff in resolving issues arising with patients and/or insurance carriers.
- Maintains current and up-to-date reference materials on rules and regulations and obtains a concise understanding of these regulations for all insurance carriers. Ensures complete compliance with all insurance rules and regulations for insurance carriers.
- Attends meetings, seminars and/or conferences as needed to maintain a current understanding of the industry.
- Works closely with the Medical Records Manager to ensure accuracy of patient demographics is maintained and insurance changes are accurately and timely relayed.
- Meets on a routine basis with Revenue Director and CFO to address issues, establish goals, modify policies, procedures and/or restructure business office as needed. Ensures that policy and/or procedure changes are communicated to teams when implemented and followed as outlined. Escalates unresolved claim or billing issues appropriately.
- Approves all refunds prepared by billing office staff ensuring compliance with internal controls or oversees coordination of such approval process.
- Ensures accurate and timely month-end, quarter-end, and year-end close processes.
- Serves as liaison between clinic or front desk and business office staff to address immediate concerns.
- Achieves a strong understanding of medical billing software, code scrubbing software, and auditing software to ensure maximum utilization and ability to troubleshoot issues as needed.
- Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. Follow chain-of-command established by supervisor when addressing protocol issues outside of the business office department.
- Required to follow OCR and departmental policies and procedures.
- Other duties as assigned.
Education and Experience
- Bachelor’s degree is required.
- Three to five years of experience in the insurance or medical industry or equivalent experience in a business/accounting department with management and collection experience required. Additional education may be substituted for experience.
- Proficient in medical billing procedures.
- Knowledge of Microsoft Office Suite and proficiency in Excel.
Certificates, Licenses, Registrations
- Leadership - Exhibits confidence in self and others; inspires and motivates others to perform well; effectively influences actions and opinions of others; accepts feedback from others; gives appropriate recognition to others.
- Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; uses resources effectively.
- Project Management - Develops project plans; coordinates projects; communicates changes and progress; completes projects on time and budget; manages project team activities.
- Conflict Resolution - Encourages open communications; confronts difficult situations; maintains objectivity; keeps emotions under control; uses negotiation skills to resolve conflicts.
- Oral and Written Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; writes clearly and informatively; Edits work for spelling and grammar; Able to read and interpret written information. Ability to communicate with clients or customers.
- Teamwork - Balances team and individual responsibilities; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
- Detail Oriented - Consistently checks and rechecks work product for accuracy. Able to manage multiple tasks while accurately performing essential job functions. Prepares accurate and thorough reports, emails, and data as required by the position.
- Confidentiality - Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy. Adheres to HIPAA guidelines.
Independence of Action
Work progress is monitored by supervisor/manager; follows precedents and procedures and may set priorities and organizes work within general guidelines established by supervisor/manager.
Directly supervises one or more employees. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Position requires acceptable motor vehicle driving history, valid and free from restrictions, and must and appropriate vehicle insurance coverage. Ability to travel between all OCR locations.
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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
(The phrases “occasionally”, “regularly”, and “frequently” correspond to the following definitions: “occasionally” means up to one third of working time, “regularly” means between one third and two thirds of working time, and “frequently” means two thirds and more of working time.)
- The work environment is the typical office environment. The employee must be able to complete their work satisfactorily in an environment where there are significant distractions, including staff, patients, and vendors walking through and conversing, telephones ringing, conversations carrying over, loud noises, and interruptions to answer questions from others.
- While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel objects, tools, or controls up to 8 hours per day. The employee frequently is required to talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms, and stoop, kneel, crouch, or crawl.
- The employee will occasionally lift and/or move up to 25 pounds and should do so in a sound and safe manner. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
- Medical, Dental, Vision coverage
- Life and AD&D Insurance
- Short Term and Long Term Disability Insurance
- Retirement savings and profit sharing plan participation
- Employee Assistance Program
- Continuing Medical Education (depending on position)
- Paid Time Off
*Benefit eligibility is dependent on employment status, and a waiting period may apply.
Orthopaedic & Spine Center of the Rockies (OCR) is an Equal Opportunity Employer and prohibits discrimination or harassment of any kind. OCR is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions are based on business needs, job requirements and individual experience and qualifications, without regard to a person's race, color, age, sex, gender identity, gender expression, marital status, sexual orientation, religion, creed, national origin, the presence of any physical or mental disability, or status as a disabled veteran, recently separated veteran, other protected veteran, or Armed Forces service medal veteran, or any other protected status.