National Billing Manager (RCM)

Job Description

Company Overview

National Partners in Healthcare (NPH) is a progressive healthcare company specializing in anesthesiology. We partner with physicians and health systems to deliver high quality care, aligning synergies and best practices to achieve superior outcomes. As a leader in the industry, we believe in developing a foundation of trust, transparency, and excellence in everything we do. The success of our company has created excellent career advancement opportunities that support a healthy work/life balance.

POSITION SUMMARY:

Ensure timely, accurate, data entry of patient demographics, charge entries to include CPT/ASA and ICD-10 codes through appropriate direction.   Training and supervision of the staff of the billing department ensuring quality work being performed.   Audit functions of the Charge Entry Department to ensure team meeting department standards in timeliness, accuracy and quality. Provide daily, weekly and monthly reports to management as requested.

Essential Duties and Responsibilities:

• Develop and monitor compliance within the billing department functions, with policies and procedures for demographic/charge entry, verification of benefits, patient eligibility and preauthorization’s.  Policies and Procedures are to update at least annually but must be updated whenever a significant change to a process occurs
• Participates in identification, development and implementation of systems to improve process cycle times and assure timely billing for all charges submitted by providers.
• Collaborates with other departments, physicians' offices and other clinical areas to ensure consistent and comprehensive demographic and financial information is obtained during the registration process.  Develops reconciliation process, to support cases received an
• Provide training and on-going education for all staff members as well as annual reviews and performance monitoring. Training must be department wide, scheduled and documented
• Monitor productivity of staff members.  Clearly communicate the standards of performance and quality expectations to all staff members. Maintain performance reports with weekly, monthly and YTD data. This data is to be at least 50% of the employee review process.
• In collaboration with upper management establish benchmarks and performance metrics for service levels.
• Monitor turnaround time for demographic/charge entry, verification of benefits, patient eligibility and preauthorization’s.
• Encourages employees to improve their skills and to expand their expertise in all facets of the operation.
• Resolves problems through thorough identification and validation of issues, recommends needed improvements and implements solutions as needed.
• Review audits of demographic/charge entry, verification and eligibility work for accuracy of data entry and provide feedback to staff in a timely and constructive manner.
• Coordinate and monitor daily online demographic downloads from provider facilities.
• Develop and monitor billing compliance with policies and procedures for billing departments. Policy/Procedures are to be updated at least annually but must be updated whenever a significant change to a process occurs.
• Ensure that all charges have a valid fee that is in line with current fee schedule.  Confirm accuracy of fees being calculated or assigned flat fees. 
• Oversee charge/demo corrections, ensuring performed upon request, in timely fashion.
• Provide feedback to direct manager of any inconsistencies, inaccuracies, incomplete records received from providers. 
• Create/maintain any cheat sheets/guides for demo/charge entry team, keeping them updated with new items/changes. 
• Audit demo/charge ques to ensure department turn around times are being met.  Identify any lags or cases not delivered for processing to management by the various facilities/divisions. 
• Oversee/work the claims on hold in the billing system timely, keeping them under 30 days from receipt.  Assign/manage/work this que until completion.  Communicate where needed to rectify/finalize the claim hold ensuring timely billing of the case.
• Develop communication plan for billing compliance updates, as well as payer regulations and guidelines that affect provider practices and billing staff procedures.
• Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered.  Report information systems security problems.
• Mentor employees, conduct performance evaluations, counsel and provide disciplinary actions to assigned personnel, in conjunction with HR and management and works to facilitate individual and team development that drives positive results.
• Maintain OSHA and HIPPA compliance.
• Keep demo/billing teams updated/informed of any new locations, facilities, divisions being on boarded providing guidance/cheat sheets of specifics or nuances before the onboard date. 
• Adhere to all company policies, procedures and Handbook
• Maintain a smooth/efficient/quality billing department

Qualifications

Education/Licensing/Certification:

• A minimum of a high school diploma is required.  Associate or bachelor’s degree in a business or health related field preferred. 

Experience:

• Prefer a minimum of two years experience in an anesthesia or clinical pain setting but related experience will be considered. 
• A minimum of three to five years prior supervisory experience required.

Knowledge and Skills:

• Excellent Verbal and Written skills 
• Flourishes in a fast-paced RCM setting
• Ability to prioritize work
• In-depth knowledge of CPT, ICD-10, HCPCS and ASA coding

• In-depth knowledge of Medicare, Medicaid, Workers Compensation guidelines and billing standards
• In-depth knowledge of patient accounting systems and the ability to adapt prior knowledge to current software
• In-depth knowledge of various facility EMRs, EPIC, Cerner etc.
• Ability to work effectively and independently with staff, physicians, and external customers
• Ability to work as a team, strong communicator, results driven, detailed oriented leader that can show empathy and hold staff accountable when needed. 
• Must have strong keyboard skills with knowledge of Microsoft Word, Excel and PowerPoint
• Must have a pleasant disposition and high tolerance level for diverse views and opinions
• Be familiar with daily batch processes
• In-depth knowledge of financial class setup and payer setup
• Ability to work independently with minimal supervision and minimal processing errors
• Ability to motivate diverse personalities within the departments
• Communicate well with the public
• Ability to read, write, and speak English

Non-Essential Duties and Responsibilities:

• Perform other duties as assigned.

Advantages of Working at NPH

• Competitive Pay and Benefits Package
• Annual Bonus
• Generous Paid Time Off
• 401K Contribution/Safe Harbor
• Flexible Work Environment
• Career Advancement Opportunities with a Growing Company
• On-site Fitness Center and Café
• Underground Parking with Badge Access

Please note that quoted salary ranges are not guarantees of what final salary offers may be. Base pay is based on market location and will vary depending on job-related knowledge, skills, and experience. Base pay is only one part of the Total Rewards that NPH provides to compensate and recognize our staff for their work. Full time positions are eligible for a discretionary bonus and a comprehensive benefits package.