Associate Manager, Billing

Role: Associate Manager, Billing

Location: Remote

Compensation: $70000 to $80000 a year

Role Summary: 

The supervisor will play a crucial role in ensuring the success of Tia’s Billing Pod and identifying trends for RCM.

The Billing Supervisor will oversee and manage the daily operations of the billing team and supporting RCM team with patient and insurance escalations. This role is responsible for supervising the team, monitoring key performance metrics, addressing escalated patient and insurance issues, and working cross-functionally to resolve complex billing, payment, and insurance-related concerns. The Billing Supervisor will also handle patient payment discrepancies, payment disputes, and insurance escalations while ensuring adherence to revenue cycle processes and healthcare regulations.

Key Responsibilities:

• Team Management & Supervision:
• Lead, coach, and mentor a team of billing specialists, assigning tasks, conducting regular 1:1 meetings, and ensuring team members are supported and developing professionally.
• Facilitate regular team meetings to review performance, discuss challenges, and provide updates on new policies or procedures.
• Monitor and report on team metrics (e.g., payment turnaround time, accuracy, volume of disputes) and identify areas for improvement.
• Address team escalations, ensuring timely and appropriate resolution.
• Billing & Payment Discrepancy Resolution:
• Handle patient payment discrepancies, including missing payments or payment errors, and work to identify and implement solutions.
• Manage patient payment disputes, collecting necessary evidence and liaising with the patient and the relevant departments to resolve.
• Insurance Escalations & Network/Credentialing Issues:
• Address insurance-related patient escalations, focusing on network status issues and credentialing denials.
• Investigate trends in network or credentialing problems based on patient escalations, working with the Revenue Cycle Management (RCM) and credentialing teams to address root causes and implement corrective actions.
• Collaborate with insurance providers and internal teams to resolve complex claims and denials.
• Cross-Functional Collaboration:
• Work closely with the Clinical Operations (ClinOps), Product, and other departments to resolve complex patient and insurance issues.
• Identify and communicate trends in patient questions, escalations, or billing errors to improve processes and reduce future issues.
• Flag Risks such as delays, errors, bugs, unexpected coverage needs, and workflow gaps early and often
• Revenue Cycle & Coding Expertise:
• Maintain a strong understanding of medical coding and its role in the insurance claims process.
• Ensure that claims are accurate and compliant with payer requirements, and support the billing team with issues related to coding or claim submission based on provider documentation
• Stay current with health insurance policies, regulations, and industry trends to ensure adherence to all billing and revenue cycle standards.

Partnering with the RCM team to improve patient billing processes

• Provide product feedback creatively, consistently, and in an actionable manner 
• Work closely with the Senior Manager, RCM to prioritize feedback and ensure scope accomplishes customer and business goals from both a workflow and patient experience lens
• Support product teams and cross functional partners in gaining a good understanding of current workflows by facilitating shadowing sessions and trainings when needed

“Conditions for excellence” Behaviors & Principles: 

Take personal responsibility You own a specific area(s) of work within the product enablement team, and your contributions propel the care team toward reaching their overall goals and ensuring an optimal patient experience. Taking personal responsibility for your day-to-day work means that you feel like the full owner of the work, and if you are behind, you take a solution-oriented approach rather than stating over capacity. You work with your team and manager to find solutions to get the work done, and feel great pride over the work you complete on this team. Prioritize contextual transparencyBecause you’re in a unique stakeholder position where you need to build alignment, understanding and ability to execute across a diverse range of people, you need to feel comfortable and lean towards leading with sharing context. Acceptance of realityThere will be work you come across that is outside of your control or limitations. In this role, you need to honor those constraints and help brainstorm creative solutions around such problems. 

Abilities / Skills:

• Healthcare & Insurance Knowledge
• Basic understanding of medical coding, health insurance policies, and patient billing processes.
• Familiarity with insurance claim processing, denials, and appeals, particularly around network status and credentialing.
• Knowledge of healthcare regulations and laws, such as HIPAA
• Execution, Initiative and Accountability
• Consistently & reliably completes assigned work within deadlines & proactively flags any risks on misses to manager with explanation & proposed solutions
• Strongly adheres to process but can navigate ambiguity and dive into new workflows without all processes
• Bias towards action
• Core Area Knowledge
• Able to quickly develop knowledge in new areas and train others on your knowledge to help build the skill set amongst the team.
• Knowledgeable of insurance and patient billing and ability to understand complex processes & how they interact with one another
• Creative & open minded
• Keen eye for opportunities for improvement in the product
• High degree of problem perception 
• Communication Skills
• Strong cross functional partnership, with a compulsion to communicate and close communication loops 
• Able to communicate clearly in a way that drives clarity, minimizes confusion, and brings both optimism & a sense of reality