CORP H&W/SR MEDICAL BILLING MANAGER

JOB DESCRIPTION

Responsible for leading, directing, managing, and evaluating all activities related to the revenue cycle to ensure complete and accurate claims processing to allow for prompt, appropriate payment from patients and third-party payers, specifically as it relates to clinical, nutrition, and pharmacy medical billing. Accountable for staying up to date on government policies and industry standards as it relates to reimbursement to ensure that company conforms to applicable guidelines and regulations. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.

RESPONSIBILITIES

• Lead policy and procedure development and participate in process improvement initiatives
• Analyze, communicate on and resolve operational issues within claims processing including financial analysis and staffing analysis
• Comply with federal and state laws, and company policies and procedures
• Implement process and technological improvements in anticipation of future organizational growth
• Create, Adjust and Monitor statistical reports to identify trends and assess deficiencies
• Benchmark the ongoing accounts receivables and drive improvements to Key Performance Indicators, including bad debt and DSO
• Develop strategic plans and programs for working with key business stakeholders impacting the revenue cycle, including contracting, operations, finance (which includes the shared service centers)
• Improve overall performance in cash collections, days in accounts receivable and net collection rates
• Direct and review process improvement and training materials for accounts receivable staff
• Investigate escalated patient complaints and compliance issues related to billing
• Work with accounting on financial reporting and interfacing of activity into the general ledger
• Maintain a thorough understanding of the following topics as they relate to claims processing operations: conditions of participation and payment for Medicare and Medicaid, information systems, and company policies and procedures
• Collaborate with HR on planning, attraction, selection, retention, and development of the team to ensure availability of talent
• Assist with special projects as assigned
• Travel to foster successful relationships with internal/external stakeholders
• Must be able to perform the essential job functions of this position with or without reasonable accommodation

• Vocational or Technical Degree and/or Bachelor's Degree
• 5+ years experience in a leadership role in revenue cycle management for a healthcare provider organization
• 5+ years of experience and thorough knowledge of CMS rules and regulations
• Demonstrated ability to maintain confidentiality and protect sensitive information
• Ability to effectively interact professionally with senior leaders
• Strong written and verbal communication skills
• Strong computer skills including Word, PowerPoint, Excel, Outlook and Teams
• Ability to manage multiple priorities and effectively achieve desired outcomes
• Excellent analytical, critical thinking, organizational and time management skills with attention to detail, accuracy, and follow-through

• Master's Degree
• Project management experience
• 3+ years of experience redlining documents and billing third-party medical claims
• 2+ years of analytical experience