Senior Manager Billing & Coding
Senior Manager Billing & Coding
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Salary Not Disclosed
1 Vacancy
Job Description
ESSENTIAL FUNCTIONS
- Manages the daytoday operations of the Billing & Coding departments to optimize performance and quality levels while ensuring most efficient use of all aspects of billing activity and initiate appropriate corrective measures as needed.
- Communicates performance data and associated actions plans to Executive Leadership.
- Identifies and implements processes to achieve key revenue cycle metrics including but not limited to Posted Charges Suspended Claims Rejection Percentage and Denial Percentage.
- Analyze large volumes of data and provide financial analysis and regularly presents trends movements and status to Senior Leadership.
- Analyze reports and identify performance gaps and initiate corrective action
- Assist in monitoring trends and collaborate with departments to resolve billing issues
- Assist in monitor staff productivity and department goals
- Assist in resolving high dollar accounts with insurance payers
- Support with monitoring key performance indicators
- Work 1:1 with managers and director to resolve issues
- Provide weekly reports on all markets
- Work with team to ensure smooth flow in business processes
- Review coding work queues on a regular basis to ensure that workloads are distributed evenly and that the department metrics are being met.
- Resolve complex patient physician and other issues when and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
- Supervises trains and orients and evaluates performance over assigned staff.
- Understands and stays abreast of payer requirements and changes within the industry. Provides training and oversight to staff to assure that these requirements are executed.
- Attends administrative meetings and participates in committees as requested.
- Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.
- Conducts regular meetings with staff to discuss third party reimbursement methodologies.
- Provides direction staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
- Keeps abreast of compliance regulations standards and directives regarding governmental/regulatory agencies and/or thirdparty payers.
- Ensure communication and education of such to the Billing department as well as other Revenue Cycle
- Research and resolve discrepancies in a timely manner.
- Support and comply with all company policies and procedures.
- Must be able to meet deadlines given by Senior Management.
- Works with sensitive and confidential materials and must be able to exercise discretion.
EDUCATION
- Bachelors degree in business or related field
EXPERIENCE
- Five years of experience in coding and medical terminology.
- Must be AAPC/AHIMA Certified with a minimum of two years of supervisory experience.
REQUIREMENTS
- Coding Certification from AAPC/AHIMA (CPC CCSP)
KNOWLEDGE
- Knowledge of the patient accounting system and provides support to staff as needed.
- Knowledge of clinicapproved coding.
- Knowledge of thirdparty fee profiles and reimbursement requirements.
- Knowledge of health insurance processing and clinic policies and procedures.
SKILLS
- Skill in advanced computer coding applications.
- Skill in identifying and resolving complex coding problems.
- Skill in exercising initiative judgment and decisionmaking to achieve organizational objectives.
- Skill in establishing and maintaining professional relationships with patients providers and the public.
ABILITIES
- Ability to delegate responsibility and authority to staff.
- Ability to be a resource for billing information and coding guidelines.
- Ability to communicate effectively verbally and in writing.
ENVIRONMENTAL WORKING CONDITIONS
- Normal office environment.
- Some travel within the community.
PHYSICAL/MENTAL DEMANDS
- Requires sitting and standing associated with a normal office environment.
- Some bending and stretching are required.
- Manual dexterity using a calculator and computer keyboard
ORGANIZATIONAL REQUIREMENTS
- HOPCo Mission Vision and Values must be read and signed.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities knowledge skills abilities and working conditions may change as needs evolve.
Required Experience:
Senior Manager
Employment Type
Full-Time
