Billing Manager

POSITION SUMMARY

The Billing Manager oversees and coordinates work of subordinate employees engaged in medical billing activities. Responsibilities include oversight of check/cash posting, accounts receivable, charge entry, edits processing, and customer service. Ensures that all targets are met and staff work is monitored and meets collections, net, gross, days in accounts receivable, and reject/edits targets. Performs more complex functions related to billing.

EXPECTATIONS

Every Adelante Leader will strive to maximize the performance and contribution of each team member to Adelante Healthcare and the community that we serve every day. Leaders will set clear performance expectations, provide on-going feedback and coaching to improve results and outcomes and provide regular performance evaluations. Leaders are also expected work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation and model for all other employees the highest standards of personal integrity, professionalism and competence.

OUR CORE VALUES

• Compassion
• Excellence
• Integrity
• Learning
• Respect
• Sustainability

ESSENTIAL SKILLS AND EXPERIENCE:

• Responsible for planning, organizing and managing billing department employees
• Responsible for the recruitment, retention, and development of billing staff
• Oversee billing operations performance in a multi-site environment
• Documented excellence in customer service with ability to interact with Leadership in developing accounts receivable goals, policies and procedures
• Support systems implementation upgrades and improvements in our billing and financial systems
• Ensure customer needs are identified, monitored, and practices modified to maximize customer satisfaction within established standards
• Motivate, facilitate, mentor and coach subordinates to deliver high quality, cost effective services. Maintain cost to collect ratios
• Ensure development of operating procedures in alignment with quality system
• Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations

REQUIRED QUALIFICATIONS:

• Bachelor degree or equivalent work experience required
• High school diploma or GED from an accredited institution required
• 7 + years of progressively responsible managerial experience in medical billing
• Excellent written and verbal communication skills
• Working knowledge of Microsoft Office suites, including Excel
• Thorough knowledge of medical terminology, anatomy, physiology and disease process
• Knowledge of medical reimbursement methodologies

NONESSENTIAL SKILLS AND EXPERIENCE:

• Demonstrated experience as an Advocate for Health Care or Human Rights
• Certification as Healthcare Financial Professional (CHFP; HFMA)
• Certification as Revenue Cycle Representative (CRCR; HFMA)
• Certification as Professional Coder (CPC; AAPC)
• Advanced experience with NextGen EPM
• Fluency in a language in addition to English (Spanish preferred)

POSITION REPONSIBILITIES/ESSENTIAL:

• Oversees work of employees engaged in reviewing visit coding, posting charges, payments, and adjustments, processing claims, working denials, customer service calls, working collections lists, maintaining related files and logs, and checking patient eligibility
• Conduct monthly staff meetings including agendas and minutes
• Anticipate the needs of staff and patients and proactively seek solutions or interventions
• Initiate coaching and work with manger for corrective action issues

• Proactively identifies problems and assists in solving payment and other business office issues
• Manages quality improvement
• Monitors processing of claims for reimbursement and ensures all necessary documentation and attachment are included with claims. Interacts with

physicians and administrators to coordinate communication of billable services to patients

• Orients and trains area employees in department policies and procedures and assists staff in carrying out their work by responding to more complex questions and problems
• Oversee and ensure accurate input into accounts receivable system required to generate reports, collection letters, and statements
• Assists in the resolution of patient complains and concerns and resolves
• Gathers and exchanges information necessary to ensure timely processing and reimbursement of claims and to promote maximum cash flow and reduce outstanding days in accounts receivable
• Runs regular reporting to monitor and ensure that department and employee goals are being met
• Helps with back-logged department responsibilities
• Ability to solve problems using a logical, systematic approach

Additional Duties and Responsibilities

• Other duties as requested or assigned.

PCMH

All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team based model to promote wellness and improve health outcomes.

Adherence to Compliance and Code of Conduct

All employees are required to comply with Adelante Healthcares written standards, including its Compliance Program and Standards of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelantes legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment characteristics 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.

Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance, and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.