Billing and Collections Manager

The Billing and Collections Manager is responsible for supervising the billing department and staff, will ensure accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections/denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers.  The Billing and Collections Manager will assist with the development of and oversee the internal collections process related to outstanding patient account balances, must possess critical thinking skills and an understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts.  In addition, the Billing and Collections Manager must demonstrate proficiency with the billing system to ensure all functionality is utilized for the utmost efficient processing of claims.

1. Supervise billing office staff.
2. Responsible for charge and payment entry within the Electronic Medical Record.
3. Establishes/oversees collections process related to outstanding patient balances.
4. Coordinates and clarifies with providers, when necessary, on information that is incomplete or is lacking for proper account/claim adjudication.
5. Responsible for correcting, completing, and processing claims for all payer codes.
6. Analyze and interpret that claims are accurately sent to insurance companies.
7. Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial Insurance Companies on unpaid insurance accounts identified through aging reports.
8. Process appeals online or via paper submission.
9. Assist in reconciling deposit and patient collections.
10. Assist with billing audit related information.
11. Process refund requests.
12. Attend provider meetings/workshops when needed.
13. Communicates with billing office and finance manager to identify and resolve audit review issues.
14. Processes billing calls and questions from patients and third-party carriers.
15. Responds to correspondence related to patient accounts.
16. Identify trends and carrier issues relating to billing and reimbursements.  
17. Reports to supervisor on a regular basis.
18. Pursue and participate in education to remain current with changes in the Healthcare industry.
19. Maintain patient confidence and protects operations by keeping patient information confidential.
20. Point of contact for all payer sources regarding billing.
21. Negotiates reimbursement rates with private insurance companies to ensure company is receiving fair and competitive rates.

The Billing and Collections Manager must possess a high school diploma or GED equivalent. Some college preferred. Supervisory experience preferred.