Job Description

PURPOSE

The Billing/Collections Assistant Manager is responsible for all functions as it relates to billing, intake, and AR collections. Requires strong managerial, leadership, and business office skills, including critical thinking, customer service and multi-tasking abilities including the ability to produce and present detailed billing and AR activity reports. Works with Medical Groups/IPAs, Physician Offices, and Insurance companies to ensure prescriptions claims are entered and billed correctly and timely and ensure prompt and accurate reimbursement. Will play a collaborative role in developing best practices and implementing monitoring activities to track performance against Company goals.

DUTIES

The duties of this position are those described below. This job description does not state or imply that the duties listed are the only duties and responsibilities assigned to this position. Employees holding this position will be required to perform any other job-related duties as requested by management.

ESSENTIAL DUTIES (These duties directly and substantially serve to achieve the purpose of the position)

· Managing a team of 10+ to include functions of billing and intake, AR collections, reconciliation payment posting, and customer follow-ups

· Implement processes and procedures for verification of patient benefits, determination of benefits eligibility, and identifying responsible parties to bill for pharmacy reimbursement

· Prepare, submit, and oversee clean claims in various methods (e.g. electronically, paper, online)

· Identify and resolve patient billing concerns and complaints

· Benefits coordination needed for billing, including collecting of required documentation, and working with referral sources, health care partners and payors to deliver patient care

· Rebill insurance companies or other third parties to secure payment and follow-up and report status of delinquent accounts

· Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers

· Establish payment plans to help patients manage payment of bills

· Perform routine claims and payments auditing to ensure compliance, data accuracy, and consistency

· Work and coordinate with other departments to streamline order processing and turnaround times

· Engages in various clerical and record-keeping duties as needed

· Seeks educational opportunities and accepts responsibilities for own professional growth and development

· Other duties as assigned

MANAGEMENT RESPONSIBILITIES

· Assists in mentoring and training of staff; proactively seeks and participates in ongoing training sessions

· Schedule staff and verify timesheets for payroll processing

· Responsible for implementing policies and procedures and training of staff

· Responsible for performance reviews for all staff

· Designing, planning and executing initiatives that meet the goals and objectives of the company.

· Fostering a positive culture and driving change management

· Actively participates in performance improvement and continuous quality improvement activities

· Implements and enforces goals, priorities and expectations for the staff

· Responsible for providing employees with timely, candid and constructive feedback; developing

employees to their full potential and providing challenging opportunities that enhance employee career growth; developing the appropriate talent pool to ensure adequate bench strength and succession planning; recognizing and rewarding employees for accomplishments

Setting up employee engagement and incentive programs

· Demonstrates flexibility in areas such as job duties and schedule in order to serve the needs of the patients and meet business goals

· Support team members and participate in team activities to help build a high-performance team.

EDUCATION REQUIREMENTS

· High school diploma or equivalent, college level a plus

EXPERIENCE REQUIRMENTS

· Must have a high school diploma

· A minimum of 3 years of experience in a supervisory role for billing, collections, or eligibility

· Proficiency in a Windows computer software (MS Word/Excel) preferred

· Excellent oral and written skills

· Exceptional interpersonal skills and team player

· Ability to work independently and self-manage

· Ability to execute “outreach plans” collect data, and prepare reports

· Follow agency policies and maintain organizational standards with regards to client confidentiality and HIPAA compliance

· Bi-Lingual English/Spanish preferred

· Valid California Driver’s License, proof of personal liability auto insurance as required by California State Law, and ability to travel/drive as required to perform essential duties

EQUIPMENT USED

· PC, Calculator, Office Copying, FAX and Scanning Machine

COMPUTER SKILLS AND APPLICATIONS

· Good proficiency in Microsoft Office Suite (Word, Excel) familiarity with PowerPoint, Outlook; ability to use the Internet for research and information in support of job duties.