Employment Opportunities
Medical AR/Billing Manager
This position is currently open.
Public?:
Internal
Division:
Health
Reports To:
Revenue Integrity Officer
Type of Position:
Regular Full Time
Location:
Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026
General Description
The Medical Accounts Receivable/Billing Manager will provide leadership, assistance, and collaboration between the Revenue Integrity Officer, Compliance Officer, and Finance Department. The AR/Billing Manager will oversee the recording of payments, reconciliation, collections, timely filing, and claim follow-up. Adhere to state and federal regulations, payer contracts, and insurance guidelines when performing insurance follow-up, resolving open accounts, and appealing claims. Assist with implementing new workflows, and act as a key contributor to the Revenue Cycle by identifying and reporting inefficiencies, and opportunities that enhance revenue flow, decrease denials, and minimize write-offs. This role will direct initiatives to improve third-party medical, dental, vision, and employee health collections, including account monitoring, and ensuring effective and efficient processing of AR/Billing functions. This position is highly visible and requires a strong leader with the ability to prioritize, plan, and firmly direct the department.
Responsibilities
Provides requested information as assigned creates or generates related reports, or locate and pull requested information for drafts or documentation and ensure that the document is reviewed and approved by health legal before it is released to patients or patient representative.
Prepares weekly deposit reports to ensure that the Revenue Integrity Officer, Compliance Officer, and Administration are current on third-party medical, dental, vision and employee health collections; this report is due every Friday.
Gathers all paper checks, and locates explanation of payment (EOP) to ensure payments and adjustments are posted to correct encounters and ensure timely deposits.
Prepares deposit log/checks received using the bank ACH remote deposit portal.
Enters deposits daily in MIP accounting software and ensure correct revenue and coding is used for easy and up to date tracking purpose.
Three way match system to reconcile third party deposit recorded in ECW, MIP accounting system and bank statement deposits daily, weekly and monthly to ensure timely hard close.
Shared oversight of Accounts Receivable Specialists and Billers.
Perform Monthly Hard Close though ECW, finalize the month-end close process and provide the reporting by the deadline to Revenue Integrity Officer for review and submission to the Health Finance Department.
Assist with posting payments, adjustments; follow-up, timely filing, and sending appeals using the Explanation of Payment (EOP) and Remittance Advice (RA) as reference document.
Verifies and audits updated financial transactions in eCW and respond to patient inquiries.
Respond to correspondence received from insurance carriers or patients.
Managed/Reconciled denied claims and put in correct work que to be worked by biller/coders.
Make appropriate decisions by researching accounts to ensure maximum reimbursement.
Identify any problems/trends and communicate with the lead biller/coder for resolution.
Must be able to communicate procedures for processing changes that may increase revenue from insurance carriers.
Work on Adjustments, including but not limited to IHS/AST adjustments.
Back up for Revenue Integrity and Compliance Officer with mail log and pick up.
Follow changes and policies within the industry; prepare plans and goals to grow, and follow company policy changes and projections that may impact ASTHA, Inc.'s services and programs.
Ensure that 100% of billable receivables are collected for assigned facilities.
Review the aging reports with facilities and provide status on balances. Back up and in charge if the Revenue Integrity and Compliance Officer are both out of the office.
Additional Duties:
As needed, communicate regularly with the Revenue Integrity Officer, Compliance Officer, and management.
Attend meetings and in-services as requested.
Assist in producing, editing, and revising various documents, including policies and procedures, job responsibilities, job expectations, performance appraisal forms, surveys, etc.
Train additional team members, as needed.
Attend continuing education activities to maximize knowledge.
Maintain needed education and certifications.
Participate in quality improvement programs as necessary.
Continuously works towards the Health System’s goal and vision.
Additional duties as assigned by the Supervisor.
Education Requirements and Qualifications
Bachelor’s degree related to health care or information systems, business, or related field required
Experience in E-clinical works Healthcare system for three (3) years
Must have a working knowledge of Medicare, Medicaid, and Managed Care reimbursement regulations.
Ten (10) years of experience in the management of clinical billing or healthcare experience required, with extensive knowledge of ICD-10-CM and CPT coding principles and guidelines
Extensive knowledge of federal regulations and policies about documentation, coding, and billing
Must know how to perform proper revenue and reimbursement capture.
Must be highly analytical, detailed, and independent.
Proven communication, organizational, and leadership skills required.
Other education and experience substituted for above requirements require approval by the Executive Director.
Knowledge, Skills and Abilities
Knowledge of revenue cycle and compliance procedures
Considerable knowledge of industry laws, regulations and policies
Ability to establish and maintain positive relationships with employees, management, clients, vendors and external contacts
Knowledge of the functional area's local, state, and federal regulatory requirements.
Ability to conduct and interpret qualitative and quantitative analysis, financial analysis, healthcare economics and business processes, information systems, organizational development, healthcare delivery systems, project management, or new business development.
Ability to manage, organize, prioritize, multi-task, and adapt to changing priorities.
Ability to provide leadership and influence others.
Ability to foster effective working relationships and build consensus.
Ability to mediate and resolve complex problems and issues.
Ability to develop long-range business plans and strategy
Physical Requirements and Working Conditions
Must be able to sit, stand, stoop, bend or kneel for long periods of time.
Sitting or standing or walking for long period of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking hearing and visual acuity.
Frequent lifting (up to 15 lbs)
Occasional lifting (up to 30 lbs)
Native American Preference/EOE/Drug Free Workplace/Smoke Free Workplace
Posted Date:
1 year 4 months ago
Closing Date:
Sunday, December 24, 2023