Billing Manager bei Medusind Inc.

Description

Medusind is a leading provider of revenue cycle management solutions to dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.

The billing manager is responsible for the daily billing and collection operations, supervises staff, ensures accurate claims and coding, monitors accounts receivable, and maintains compliance with federal and state regulations. Key responsibilities include training and developing staff, identifying, and implementing process improvements, preparing financial reports, and serving as a liaison with insurance companies, clients and internal departments. This position is responsible for ensuring maximization of cash flow while improving patient, physician, and other customer relations. 

This position requires the selected candidate to be on site for the first 3-6 months. 

Key Responsibilities:

Operations:

• Oversee the operations of the billing department encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management, working to reduce outstanding balances and improve cash flow. 
• Serve as the practice expert and go to person for all coding and billing processes. 
• Plan and direct patient insurance documentation, workload coding, billing and collections, and the data processing to ensure accurate billing and efficient account collection.
• Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulations, guidelines, and requirements.
• Spearhead payor projects, resolving complex billing issues, discrepancies, and claim denials.
• Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
• Maintains contacts with other departments to obtain and analyze additional patient information to document and       process billings.
• Follow up on claims using various systems, i.e. practice management and clearinghouse.

Leadership & Development:

• Provides, oversees, and/or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques. 
• Develop and implement standard operating policies and procedures.
• Supervise billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
• Coordinates team member time off in a manner that does not negatively impact necessary daily functions. 

Reporting and Analytics:

• Prepare, analyze and present accounts receivable reports, and daily, weekly, and monthly financial reports. 
• Monitor KPIs, SLAs, month-to-date targets, and productivity. Present findings to management on a daily, weekly, monthly, and quarterly basis. 
• Audit current procedures to monitor and improve efficiency of billing and collections operations. 
• Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures. 

Continuous Improvement:

• Keep up to date with carrier rule changes and distribute the information within the practice. 
• Perform physician credentialing actions.
• Understands and remains updated with current coding and billing regulations and compliance requirements.
• Contribute to internal process documentation and training materials.
• Maintains library of information/tools related to documentation guidelines and coding.

Requirements

Education:

• Associates degree, preferably in business administration or related field; bachelor’s degree preferred. 7+ years of medical insurance/healthcare revenue cycle experience will be considered in lieu of the degree. 

Experience:

• Minimum of 3 years medical insurance/healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations. Physical therapy preferred. 
• Two years’ supervisory or management experience preferred.
• Medical coding/industry-related certification a plus.
• Experience working in Cerner, eClinicalWorks, and/or Athena a plus.

Communication & Collaboration: 

• Strong communication, negotiation, and interpersonal skills. Ability to work independently and as part of a collaborative team.

·Detail-Oriented: 

• Exceptional problem-solving abilities and attention to detail to ensure accuracy in billing. 
• Ability to set and maintain priorities in a fast-paced client-focused environment, with multiple demands and interruptions.

Collaborative Problem Solving: 

• Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, etc.

Technical skills: 

• Advanced proficiency in RCM software and Microsoft Office Suite, data analytics, and process improvement initiatives. Leveraging technology and automation to enhance efficiency and accuracy. 

Adaptability and flexibility: 

• Should be able to adapt to changes in regulations, technologies, and industry trends and adjust the revenue cycle management strategy accordingly.

Performance Management: 

• Ability to monitor team performance and make adjustments as needed to improve team and individual performance.