Mgr, Claims & Billing-Physicians at WakeMed Health & Hospitals

Overview:Provides general daily management of the Claims and Billing Department. Duties may include but are not limited to the following: Develops processes and procedures that will monitor billing outcomes. Responsible for analyzing rejections and denials for payment. Implements strategies to eliminate errors and reduce the rejection rate. Updates and develops policies and procedures based on billing needs and requirements as necessary. Works with other WakeMed departments and staff on a daily basis to troubleshoot and resolve day to day operational issues relating to billing and the processing of claims. Responsible for serving as a connection between the Department and other departments within WakeMed. Allows the access for WakeMed departments to be able to work in the insurance carriers? websites for eligibility and claim status. Approve time sheets and time off. Ability to handle all tasks and projects given and directed by the Patient Account Director. Serves as a reference for staff problems. Plans and supervises the activities of the section to ensure proper and timely billing of all accounts; directs the billing of insurance companies, patients, including the responsibility for the processing of claims or denials, the resubmission of denied claims and the appeal process. Assists the Claims and Billing Director in the development of fiscal controls, ensuring conformance with the guidelines and policy of fiscal intermediaries, the physician practices and standard fiscal procedures; recommends and implements new or revised methods and procedures to improve billing operations; develops written procedures and manuals to implement changes or clarify standard practices. Reviews current manuals, health regulation updates, and other changes to determine the impact on billing and related functions; presents recommendations in verbal or written form; conducts special studies on matters related to the operation of the section including work-flow patterns, error trends, staff and space utilization, equipment needs, training and other areas of concern. Research accounts: resolves or handles the more difficult and complex billing problems, appeals, and complaints. Confers with department heads, medical staff, supervisors and patients; coordinates the work of the section with other Medical Center Divisions, i.e., Data Processing, Medical Records, etc. Prepares and audits claims, statements and reports from a variety of sources; performs technical accounting work; monitors accounts receivable and prepares reports. Provides support to other staff as required. Performs other duties as assigned.Department Description:

Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.

EOE

Licensure:Not ApplicableEducation:Associate's Degree Required - And Bachelor's Degree PreferredExperience:2 Years Leadership And 3 Years Accounting/Finance - Revenue Cycle In Healthcare Required - With Preferred Education 3 Years Leadership And 5 Years Accounting/Finance - Revenue Cycle In Healthcare Required - With Required Education Apply Now