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Job Details

Manager, Hospital Billing

Category: Professional and Management
Location:
Commerce Place, Malden, MA

Department: Medicare/Medicaid Billing
Job Type: Full Time
Job Class: Non-Union
Work Shift: Days
Work Days: 40 Hours
Hours/Week: 40
Date Posted: 10/15/2020
Requisition Number: hrq-105405

Job Details

  • The Billing Manager is responsible for the day-to-day operations and management of staff, processes and outcomes in this unit. The Manager monitors workflows, delegates assignments and work to staff, ensures adequate coverage for operations, provides written protocols and expectations for staff, development and assessment of staff through the use of staff performance and productivity measures and completes human resource functions. Oversees the professionalism, customer satisfaction, and service excellence of staff. The Manager also coordinates department processes with other revenue cycle departments to improve quality data collection, minimize denials, set standards and streamlined processes.

    Specific to this position, the manager oversees all departmental duties and responsibilities including but not limited to: hospital or physician patient account operations and activities including the timely and accurate preparation and production of claims; timely denial and rejection work; timely and accurate collection of cash, adjustment and refund codes; and accurate resolution of credit balances and close out of bad debt. The installation and adequacy of control system; resolution of all system problems and use of AR operations report production to identify billing issues. The identification and resolution of all clinic registration and charge entry problems; and the identification and resolution of all patient-billing problems. Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines and requirements. Keeps up to date with carrier rule changes and distributes the information within the department.

    Qualifications:

    Bachelor's degree preferred. Seven to ten years of experience in a healthcare or related setting managing staff, operations and the ability to lead diverse staff. Demonstrated goal-oriented thinking, leadership ability, and strong interpersonal, operational and organizational skills. Demonstrated ability to establish a professional code and work environment with the ability to remain professional, even when working through difficult situations. Demonstrated ability to take initiative, effectively assess, research issues through strong problem-solving skills as well as collaborating with other departments to solve problems. Ability to support and promote the understanding of organization mission and goals. Ability to communicate with clients including patients, providers, and other office managers effectively. Experience and solid understanding of hospital information systems such as Epic. Strong software skills utilizing Google and Microsoft office products such as spreadsheets, word processing, presentation software, email and conference calls. Demonstrated comprehensive and thorough knowledge of all third party rules and requirements as they relate to billing and payments. Working knowledge of CPT and ICD10 codes, and ability to read 837 (UB04 claim forms and 1500 claim forms) and 835 payment files, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes. Demonstrated experience in the automation of patient accounts billing system activities and experience in working with clinical, ancillary department and primary care leaders to resolve problems.

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