Medical Billing Manager

LV Search Partners • las vegas, nv, us • 3m ago

Requirements:

Bachelor’s degree in healthcare or Associate’s degree with 5 years of healthcare or revenue cycle experience, Masters in healthcare is preferred.
4+ years of managerial experience in healthcare billing.
Physician office or insurance experience, multi-specialty setting preferred.
Certifications such as Certified Professional Coder (CPC), Certified Professional Biller (CPB), Certified Physician Practice Manager (CPPM) or other equivalent certifications are major pluses.

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About the Role

The Medical Billing Manager will manage and provide supervisory oversight to the billing department while maintaining and improving billing efficiency and the revenue cycle.

Responsibilities

Exhibit a high level of professionalism toward all stakeholders, including the Board, employees, volunteers, patients and their families, and partners while creating and maintaining strong working relationships.
Support current patient needs and maximize potential with new patients and organizations for the future.
Understand, align with, and act in accordance with the organization’s vision and mission.
Oversee daily operations, delegate workload, and provide backup coverage to facilitate timely and accurate completion of tasks for Eligibility, Medical Billers, and Patient Financial Counselors.
Demonstrate proficiency in coding and billing hematology, oncology, orthopedic and rheumatology office visits, infusions, hospital charges, orthotics and orthopedic surgery services, radiology, physical therapy, and behavioral health services.
Complete eligibility verification for all payers including Commercial, Managed Care, and HMO policies.
Obtain required authorizations or referrals for office visits.
Monitor and remain compliant with federal, state and payer specific regulations within relevant specialties.
Oversee procedures and workflows to identify root cause for deficiencies, implement workflow improvements, system automations, corrective measures, or education to resolve and maintain billing accuracy while preventing future errors.
Collaborate with the Authorization & Referral Manager and the Patient Account Representative from Claims to identify payer denial trends or billing practices that impact patient balances.
Engage with and lead revenue cycle team meetings with the reporting manager and Authorization and Referral Manager to identify and resolve departmental issues.
Formulate and execute department strategic initiatives in conjunction with the leadership team.
Identify opportunities and implement initiatives to improve processes within the team and inter-departmentally.
Monitor assistance programs and ensure that they are offered to patients, families, and caregivers.
Oversee the hiring, onboarding, training, and ongoing success of team members.
Create and maintain SOPs for billing department tasks and duties while ensuring compliance.

Requirements

Have the desire to make changes for the better, pave the way, and do the research needed to identify new solutions.
Possess extensive knowledge in CPT and ICD-10 coding, and medical terminology.
Knowledge in commercial, managed care, HMO and other insurance plan benefits and coverage.
Ability to creatively integrate competing demands of a multi-specialty setting into a productive working environment.
Relate quickly and confidentially to patients and families, physicians, and internal teams.
Must comply with Infection Control Policy
Familiarity with AllScripts/Veradigm and/or Phreesia is a plus.

Benefits