Billing Manager

  • CAPWN
  • Jan 13, 2022
Full time Account / Finance Admin / Management

Job Description

SITE LOCATION: Gering, NE

FULLTIME position working 40 hours per week

MONDAY through FRIDAY 8:00am to 5:00pm

Reports to: Chief Financial Officer

Areas of Responsibility: Responsible for developing and analyzing financial data associated with the revenue cycle, Medicaid, Medicare, third party reimbursement, and business operations. Initiate and develop relationships with partners including, but not limited to, billing insurance companies in order to gather and process information or resolve issues to receive accurate reimbursement. Responsible for providing and analyzing day-to-day programmatic data reports using the Electronic Practice Management System (EPM)

Major Duties:
1.    Works collaboratively with and serves as the liaison to billing company
2.    Manage the day to day billing operations, assure that all information provided to billing company is accurate and timely
3.    Coordinates with program directors in the development and delivery of program specific billing reports.
4.    Responsible for denial work file management, collaborating with billing staff to ensure claims processing occurs in a timely manner
5.    Responsible for entire pipeline of charge capture activities from encounter form development and review to correct coding and oversight for ensuring accurate reimbursement for services billed
6.    Reviews billing and collection patterns and makes corrective recommendations.
7.    Assures daily posting of patient payments and all other non-ERA/EOB third party payment including hospital and nursing home visits.
8.    Assures adjustments are made appropriately in the Centricity system for all sliding fee patients.
9.    Manages the monthly reconciliation process to ensure that all procedures/operative cases are billed in a timely manner. Analyzes month end reports presented by billing vendor, identifying opportunities for work process improvements with respect to claims denials.
10.    Oversees and provides input to ensure all systems are functional in categories such as dictionary file, data elements, interface and mapping, payer specificity, file transmission, billing area set, adding/deleting ICD9 and CPT codes, etc.
11.    Assures timely identification of patient accounts with credit balances and processing of refunds.
12.    Assure small balance adjustments are done monthly before patient statements are issued.
13.    Work with Customer Service Supervisor to ensure front desk staff is trained and knowledgeable on insurance verification and patient demographics.
14.    Maintain user access on insurance verification websites
15.    Coordinates and facilitates billing compliance audits for the Clinic. Oversee the dissemination of coding changes and education to providers. Provides feedback and education to providers on coding errors for both procedure and E&M services. Verifies that fee schedules are appropriate against insurance payers' allowable fees.
16.    Updates/adds fee schedules and payer contracts in billing software.
17.    Analyzes monthly charges and payments data to ensure billing vendor is on track to meet established targets for productivity. Reviews EOBs as needed to determine/address payer problems. Coordinates efforts with program directors regarding program specific billing reports and authorization issues.
18.    Oversees the generation and accuracy of assigned billing staff monthly program specific reports.
19.    Oversees billing staff daily work activities and performance reviews.
20.    Responsible for Practice Management System billing maintenance
21.    Coordinate with CFO on updates Billing Policies and Procedures pertaining to financial management of the Clinic and affiliated health facilities.
22.    Maintain the client sliding fee schedule and update as needed.
23.    Other duties as assigned.


Working Conditions:
•    General office environment: Work is generally sedentary in nature but may require standing and walking for up to 10% of the time.

Physical Requirements:
•    Must be able to read, write, and communicate fluently in English. Must have good vision.
•    Must be physically and emotionally able to work clients, vendors, and other employees.
•    Must regularly talk, hear and have close vision ability.
•    Ability to bend, stoop, squat, crouch, push and pull file drawers.
•    Fine manipulation of the hands with repetitive action.
•    Operate office machines, printers, computers, adding machines.
•    Occasionally lifting and carrying up to 35 pounds.

Minimum Qualifications:

Grade: 17
1.    Minimum of an Associate's Degree in accounting or business-related field or five years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience;
2.    Minimum of three years of management experience;
3.    Knowledge of ICD10 and CPT coding;
4.    Minimum of three years of work experience with electronic medical record systems clinical systems.
5.    Knowledge of professional fee billing, reimbursement and third-party payer regulation and medical, behavioral health and dental terminology.
6.    Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations
7.    Experience with the provider credentialing process is preferred

Grade 18
1.    Meet the minimum qualifications above;
2.    Bachelor’s degree in accounting or business-related field
3.    Five years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience; and
4.    Five years of management experience.

Grade: 19
1.    Meet the minimum qualifications above;
2.    Seven years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience; and
3.    Seven years of management experience.

Job Requirements

SITE LOCATION: Gering, NE

FULLTIME position working 40 hours per week

MONDAY through FRIDAY 8:00am to 5:00pm

Reports to: Chief Financial Officer

Areas of Responsibility: Responsible for developing and analyzing financial data associated with the revenue cycle, Medicaid, Medicare, third party reimbursement, and business operations. Initiate and develop relationships with partners including, but not limited to, billing insurance companies in order to gather and process information or resolve issues to receive accurate reimbursement. Responsible for providing and analyzing day-to-day programmatic data reports using the Electronic Practice Management System (EPM)

Major Duties:
1.    Works collaboratively with and serves as the liaison to billing company
2.    Manage the day to day billing operations, assure that all information provided to billing company is accurate and timely
3.    Coordinates with program directors in the development and delivery of program specific billing reports.
4.    Responsible for denial work file management, collaborating with billing staff to ensure claims processing occurs in a timely manner
5.    Responsible for entire pipeline of charge capture activities from encounter form development and review to correct coding and oversight for ensuring accurate reimbursement for services billed
6.    Reviews billing and collection patterns and makes corrective recommendations.
7.    Assures daily posting of patient payments and all other non-ERA/EOB third party payment including hospital and nursing home visits.
8.    Assures adjustments are made appropriately in the Centricity system for all sliding fee patients.
9.    Manages the monthly reconciliation process to ensure that all procedures/operative cases are billed in a timely manner. Analyzes month end reports presented by billing vendor, identifying opportunities for work process improvements with respect to claims denials.
10.    Oversees and provides input to ensure all systems are functional in categories such as dictionary file, data elements, interface and mapping, payer specificity, file transmission, billing area set, adding/deleting ICD9 and CPT codes, etc.
11.    Assures timely identification of patient accounts with credit balances and processing of refunds.
12.    Assure small balance adjustments are done monthly before patient statements are issued.
13.    Work with Customer Service Supervisor to ensure front desk staff is trained and knowledgeable on insurance verification and patient demographics.
14.    Maintain user access on insurance verification websites
15.    Coordinates and facilitates billing compliance audits for the Clinic. Oversee the dissemination of coding changes and education to providers. Provides feedback and education to providers on coding errors for both procedure and E&M services. Verifies that fee schedules are appropriate against insurance payers' allowable fees.
16.    Updates/adds fee schedules and payer contracts in billing software.
17.    Analyzes monthly charges and payments data to ensure billing vendor is on track to meet established targets for productivity. Reviews EOBs as needed to determine/address payer problems. Coordinates efforts with program directors regarding program specific billing reports and authorization issues.
18.    Oversees the generation and accuracy of assigned billing staff monthly program specific reports.
19.    Oversees billing staff daily work activities and performance reviews.
20.    Responsible for Practice Management System billing maintenance
21.    Coordinate with CFO on updates Billing Policies and Procedures pertaining to financial management of the Clinic and affiliated health facilities.
22.    Maintain the client sliding fee schedule and update as needed.
23.    Other duties as assigned.


Working Conditions:
•    General office environment: Work is generally sedentary in nature but may require standing and walking for up to 10% of the time.

Physical Requirements:
•    Must be able to read, write, and communicate fluently in English. Must have good vision.
•    Must be physically and emotionally able to work clients, vendors, and other employees.
•    Must regularly talk, hear and have close vision ability.
•    Ability to bend, stoop, squat, crouch, push and pull file drawers.
•    Fine manipulation of the hands with repetitive action.
•    Operate office machines, printers, computers, adding machines.
•    Occasionally lifting and carrying up to 35 pounds.

Minimum Qualifications:

Grade: 17
1.    Minimum of an Associate's Degree in accounting or business-related field or five years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience;
2.    Minimum of three years of management experience;
3.    Knowledge of ICD10 and CPT coding;
4.    Minimum of three years of work experience with electronic medical record systems clinical systems.
5.    Knowledge of professional fee billing, reimbursement and third-party payer regulation and medical, behavioral health and dental terminology.
6.    Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations
7.    Experience with the provider credentialing process is preferred

Grade 18
1.    Meet the minimum qualifications above;
2.    Bachelor’s degree in accounting or business-related field
3.    Five years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience; and
4.    Five years of management experience.

Grade: 19
1.    Meet the minimum qualifications above;
2.    Seven years of direct Medicaid/Medicare/private or other commercial insurance billing and accounting experience; and
3.    Seven years of management experience.

Loan Forgiveness?

No