Medical Billing Manager

Role Overview

• Responsible for the billing team leadership, subject matter expertise, and organizing and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for services rendered by NHC providers;
• Supervise and coordinate the workload of the billing staff to ensure all tasks are completed accurately and in a timely manner.
• Define and communicate current and new billing tasks and definitions of the billing team.
• Recommend and report billing issues of concern or accommodation to the clinic manager for action.
• Run, work, and manage reports for the purpose of verifying quality and completeness of various data entry and other functions in EPIC.
• Communicate with NHC staff about missing and erroneous data and ensure the completion and correction of the same.
• Work collaboratively with other members of the organization to maximize accuracy, efficiency, and promptness of the claim life cycle.
• Troubleshoot other problems in various billing processes and document to resolution problems discovered.
• Maintain and control documentation of billing processes.
• Execute quality control processes to ensure consistent billing and collection.
• Monitor third party coverage contracts, ensuring that current contractual terms are understood and applied correctly.
• Assist accounting with reconciling EPIC monthly deposit reports to the general ledger deposits.
• Assist CFO in completion of the annual cost reports, financial audit, annual UDS report, and any other required annual governmental reporting.
• Create and foster an environment that encourages professional growth of billing specialists.
• Other duties as assigned.
• Study and evaluate new and changing billing requirements and recommend solutions.
• Work directly with managers to revise processes and resolve issues.
• Document significant billing changes and methods for management awareness.
• Monitor changing standards and methods in billing to ensure NHC methods and processes are current.
• Manage and coordinate the billing team’s work results for quality, accuracy, and timeliness.
• Oversee and review the transmission of claims in EPIC as well as other electronic and paper claim processing.
• Follow up on unpaid claims within standard billing cycle timeframe.
• Oversee payment processing for accuracy and compliance.
• Provide customer service to patients enquiring about their accounts and process requests for refunds.
• Provide ongoing orientation and training to staff.

Requirements

• Associate’s degree in medical billing and coding preferred or a combination of education and experience.
• Minimum of five years’ progressive billing experience required, including supervisory duties.
• FQHC experience.
• Mastery of insurance basics and practices.
• Mastery of medical billing terminology.
• Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Familiarity with CPT and ICD-10 coding.
• Working knowledge of NHC’s practice management system, EPIC.
• Certified coding certificate or comparable experience required.
• Ability to work without constant supervision and adhere to policies and procedures.
• Ability to work remotely via a home office set up with access to secure Internet connection.
• Ability to read, write, speak, and comprehend English fluently.
• Vaccines as required.

Benefits

• N/A