Offer summary

Qualifications:

High school graduate or GED equivalent required; Associates or Bachelor’s Degree preferred., Minimum of 3 years previous hospital billing experience is necessary., Strong knowledge of insurance regulations, procedure and diagnosis coding, and automated insurance billing is essential., Excellent communication, critical thinking, organizational, and time management skills with attention to detail are required..

Key responsibilities:

Oversee claims production, billing, follow-up, collections, and compliance with third-party payer regulations.

Provide operational oversight and mentorship to the Billing Coordinator.

Monitor trends in statistical reports to identify operational deficiencies and implement corrective actions.

Ensure accurate and timely billing of accounts while maintaining confidentiality of patient information.

Job description

The Billing and Posting Resolution Advocate is responsible for overseeing claims production, billing, follow-up, collections, and compliance with third party payer regulations. This position is responsible for daily oversight and management of process-based revenue cycle functions, including ongoing improvement to key revenue cycle indicators. These indicators include but are not limited to: A/R days, cash collection goals and posting, denials, underpayment and contract management activities related to patient account management. The Billing Manager should have comprehensive knowledge of revenue cycle operations. The position is responsible for personnel development and initiating disciplinary action according to policy.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.
Provides operational oversight for the Billing Coordinator, mentoring them in their responsibilities
Maintains current knowledge of hospital billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practices
Demonstrates ability to manage, train and motivate employees, as well as a professional attitude in relating to executive management, professionals and third-party insurance carriers.
Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.
Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary
Pro-active communication/escalation of potential claims/unbilled accounts/issues to the Director
Exhibits excellent leadership and self-direction, good judgement in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills.
Assures that confidentiality of patient information is maintained without exception
Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices.
Liaise with facility management and operates as the lead point of contact
Maintain employee time and attendance and scheduling demands
Responsible for accuracy of customer invoices, and creating the invoices monthly
Understanding the contract terms and insuring we stay within those terms
Performs all functions from the Management Expectations List
Performs all other duties assigned

Minimum Requirements:

Education/Experience/Certification Requirements

High school graduate or GED equivalent
3 years previous hospital billing experience
Working knowledge of insurance regulations, procedure and diagnosis coding and automated insurance billing
Excellent communication (written and oral) and interpersonal skills
Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow through
Must be able to work through issues to resolution

Preferred Qualifications: