Medical company is looking for a Billing Manager to join their growing team located in Los Angeles.

Job purpose

Management position responsible for directing and coordinating the overall functions of the medical billing office to ensure maximization of cash flow while improving patient, physician, and other customer relations. Requires strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.

Duties and responsibilities

• Oversees the operations of the billing department, encompassing medical charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
• Serves as the go to person for all coding and billing processes
• Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
• Analyze billing and claims for accuracy and completeness; oversees claims submitted to proper insurance entities and follow up on any issues.
• Follow up on claims using various systems.
• Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings.
• Prepares and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts in. Collects and compiles accurate statistical reports and delivers the billing departments milestones during the Financial Month End and Years process.
• Audits current procedures to monitor and improve efficiency of billing and collections operations.
• 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.
• Participates in the development and implementation of operating policies and procedures.
• Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
• Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures.
• Learns and implements updates and set-up, as appropriate for all billing software; coordinates proper accounting adjustment codes with Controller and updates all codes and Fee Schedules annually.
• Coordinates with RCM manager daily
• Coordinates with RCM and FPNA re: deviations in budget vs actual collections, Fee Schedule and/or billing performance
• Keep up to date with carrier rule changes and distributes the information within the practice.
• Understands and remains updated with current coding and billing regulations and compliance requirements.
• Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
• Maintains library of information/tools related to documentation guidelines and coding. Annually reviews and updates SOP’s related to these tools and information and billing training.
• Supervises billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
• Provides, oversees, and/or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques.
• Coordinates team member time off in a manner that does not negatively impact necessary daily functions.
• Management and leadership duties include: ensures confidentiality of sensitive documents which include employee's work file, pay, disciplinary action taken, etc., hiring/evaluation of billers, supervisors and assistants required to run a successful billing department.
• Other duties as assigned

Qualifications

• Thorough understanding of medical and facility billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of payer regulations and contracts
• Working knowledge of CPT and ICDl0 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes
• Knowledge of business management and basic accounting principles to direct the billing office
• Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers
• Possess excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a health care setting
• Up to date with health information technologies and applications
• Types 35-45 WPM

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