Optimum RTS - Billing and Collection Manager
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Billing and Collection Manager

Location : Fort Pierce
Job Type : Direct
Hours : Full Time
Required Years of Experience : 5 + Managerial
Required Education : Associates / Bachelors
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - Laboratory/Pathology Services

Job Description :

Billings and Collection Manager




Under general direction, position is responsible for maintaining revenue by establishing, implementing, and controlling billing system and managing staff in an out of network laboratory. Position should be able to work independently and exercise sound judgment.


 


SUPERVISION:


 


Position manages billing & collections personnel


 


MAJOR DUTIES AND RESPONSIBILITIES:





  • Supervises billing office personnel and oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.

  • Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.

  • Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.

  • Prepares and analyzes accounts receivable reports, and weekly and monthly financial reports. Collects and compiles accurate statistical reports.

  • Audits and analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures.

  • Completes required trainings, and additional recommended trainings that can help promote compliance with a variety of employment obligations.

  • In addition to the major duties and responsibilities listed above, this position will be responsible for special projects and assignments on an as needed basis.


Insurance Billing and Client Billing - Responsible for the accurate and timely processing of items relating to Claims and Client Billing in accordance with established policies, procedures and predetermined schedules:


 



  • Oversees the generation and submission of all claims, to include Commercial Insurance, Medicare, and Self Pays.

  • Ensures billing operations are performed in an accurate and timely manner, includes work allocation.

  • Monitors claim rejections and exclusions, and assists in solving issues.

  • Audits all accounts, to verify all back billing is completed in a timely manner.

  • Work directly with the collection’s personnel, on resolving any billing denial issues that may arise.

  • Ensure claims are re-submitted correctly, to solve any billing issue denials.

  • Evaluates billing processes and procedures and assists management in developing revisions.

  • Generate client bill breakdowns, accurately price out and organize individual panels or tests.


Required Qualifications :

REQUIREMENTS:


 


EDUCATION AND/OR TRAINING:  


 


Associates degree or equivalent combination of education.


 


EXPERIENCE:


 


Minimum of five-year experience managing the billing and collections department of an out of network laboratory or performing responsibilities in a similar position within a computerized environment. Familiarity with Medicare billing guidelines. Expert level of knowledge in CPT and ICD-10 coding, and/or HCPCS Coding Systems as well as claim form CMS-1500, medical terminology and medical compliance requirements.  Knowledge of CMD medical billing process a plus. Proficiency in Microsoft Office (Excel, Word, Outlook).




SKILLS AND ABILITIES:


 



  • Ability to accurately process high volumes of work within a short period of time. 

  • Ability to analyze, evaluate and report data without oversight. 

  • Ability to apply policies and procedures; performs job safely with respect to others, to property, and to individual safety and works effectively with others.

  • Ability to prioritize, meet deadlines and maintain strong working relationships with others, internally and externally. 

  • Ability to multitask in a fast-paced environment and willingness to adapt to change.

  • Prolonged periods of sitting at a desk and working on a computer.

  • Ability to lift 40 pounds.


 


OTHER CRITERIA:


 



  • Services clients nationwide.

  • Maintains strict confidence of patient, client, company and employee information.

  • Proudly services the company by following all HIPAA, JCAHO, state, and federal laws and standards.

  • Positive attitude and team player.

  • Excellent organization skills, verbal and communication skills.

  • Accepts ownership for all tasks and responsibilities.

  • Actively explores new educational pursuits to improve job knowledge and skills

  • Maintains perfect attendance and punctuality.

  • Expected to work whatever hours are necessary to accomplish the goals and deliverables of this exempt position.



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