Billing Manager

Position Summary

The Billing Manager oversees the Billing Department.

This position supervises all claims (HCFA, UB92s) on a weekly basis, reviews claims for completeness or errors, and fixes all minor errors, such as missing CPT codes and ICD-9. Requires extensive knowledge in medical billing, HMO encounter data, and CHDP reporting. May perform other clerical and billing duties as assigned by the Controller or Executive Director.

Schedule:

Flexible, may require some evening and weekends

Hours worked per week may exceed 40 hours

Primary Duties and Responsibilities

Supervise and oversee the Medical Billing Supervisor, Medical Billing Lead, Medical Billers, and the Medical HCC Coder.

Review all claims for completeness and errors and correct them accordingly.

Monitor the submission of encounter data (HCFA 1500) to the appropriate health plans.

Review all denials for complexity, make corrections, and resubmit claims within 30 days of the denial received date.

Monitor the billing of the BCDP, CHDP, Medi-Cal, CPSP, PPP, EAPC, HMO, Medicare, and other funding sources.

Responsible for running all billing reports, researching reports for re-bills, and maintaining report books by funding source.

Assist with pulling all required medical billing documents needed for site sites for all clinics and administrative audits.

Review weekly billed report with department manager.

Inform clinic managers of unbilled or go-backs claims on a daily/weekly basis.

Generate weekly revenue report status to management team.

Other duties assigned by the Controller or Finance Director.

Qualifications

Minimum Requirements
• Microsoft Office/Word/Excel/Outlook
• Excellent Communication Skills, with the ability to interpret medical billing issues
• Excellent Customer Service Skills
• Knowledge of Medi-Cal reimbursement guidelines preferred
• Bi-lingual Spanish/English (preferred)
• Ability to relate well to the cultural and ethnic characteristics, as well as, the population served by the organization
• Excellent Leadership Skills
• Reliable transportation
• Must be able to travel from facility to facility
• This position requires 10 % travel with frequent travel outside the local area. Some overnight and/or interstate travel.

Required Education/Experience and/or Licensure/Certification
• Bachelor’s Degree in healthcare, finance, or related field or equivalent work experience
• Minimum of three years’ experience in medical billing and coding experience
• Must have at least one year experience as a Medical Billing Manager
• Diploma in Health Claims Examiner/Medical Biller
• Commitment to goals and philosophy of Northeast Community Clinic
• Valid State Identification

Physical Requirements and Working Conditions
• OSHA Category 3 – Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment.
• The work is majority of the time sedentary in nature.
• The employee is regularly required to communicate, frequently required to use repetitive motions, move, remain stationary, regularly push, pull and lift up to 20 pounds and occasionally push, pull and lift up to 40 pounds.
• Must possess mobility to work in a standard office/clinic setting (in some cases both settings) and to use standard office/clinic equipment, including a computer, stamina to maintain attention to detail despite interruptions, read printed materials and use a computer, and communicate in person and over the telephone.