7+ years of relevant experience in hospital billing operations
3+ years of supervisory or management experience
Bachelor's degree in healthcare or related field
In-depth knowledge of medical billing codes (ICD-10, CPT)
Proven skills in revenue cycle management
Strong analytical and problem-solving abilities
Proficiency in electronic health records (EHR) systems and billing software
Responsibilities
Oversee the entire hospital billing operation for accurate and timely claims submission
Manage and lead a team of billing specialists, enhancing productivity and performance
Ensure compliance with healthcare regulations and billing guidelines
Analyze billing data to identify trends for revenue cycle optimization
Generate comprehensive billing reports to track key performance indicators
Build and maintain relationships with insurance payers to resolve billing disputes
Participate in additional duties as assigned, with a hybrid work model
Benefits
Hybrid work flexibility between remote and office work
Opportunities for staff development and training
Access to comprehensive healthcare and compliance resources
Engagement with various stakeholders across departments
Opportunity to impact revenue cycle strategies and optimization efforts
Full Job Description
Overview
Description
RESPONSIBILITIES:
A Senior Manager of Hospital Billing oversees the entire hospital billing operation, ensuring accurate and timely submission of patient claims, managing a team of billing specialists, resolving complex billing issues, maintaining compliance with healthcare regulations, and implementing strategies to optimize revenue cycle management and maximize revenue collection for the hospital.
Key responsibilities may include: 1. Team Leadership and Supervision: - Manage a team of billing specialists, including assigning tasks, performance evaluations, coaching, and staff development. - Monitor team productivity and identify areas for improvement to streamline billing processes. 2. Billing Operations Management: - Oversee all aspects of the hospital billing cycle, including patient registration, charge capture, coding, claim submission, accounts receivable follow-up, and payment posting. - Ensure accurate and timely billing by reviewing coding and charge entry for compliance with medical billing guidelines. - Monitor and address billing denials, appeals, and outstanding accounts receivable. 3. Compliance and Regulatory Adherence: - Stay updated on current healthcare billing regulations, including ICD-10, CPT codes, and payer policies. - Implement procedures to ensure compliance with HIPAA, Medicare, and other relevant regulations. - Conduct regular audits to identify and address potential billing compliance issues. 4.Revenue Cycle Optimization: - Analyze billing data to identify trends and opportunities for revenue improvement. - Develop and implement strategies to increase collection rates and reduce outstanding accounts receivable. - Collaborate with other departments like patient registration and clinical staff to improve data accuracy and streamline billing processes. 5. Financial Reporting and Analysis: - Generate comprehensive billing reports to track key performance indicators (KPIs) like denial rates, days sales outstanding (DSO), and revenue cycle metrics. - Analyze financial data to identify areas for cost reduction and revenue enhancement. 6.Payer Relations: - Build and maintain relationships with insurance payers to address billing issues and negotiate reimbursement rates. - Monitor and resolve billing disputes with payers. 7. Additional Duties as Assigned This role is a hybrid position splitting time between working remotely and working in the office.
Minimum Qualifications:
Minimum of 7 years of related experience - Minimum of 3 years of supervisory or management experience - Bachelors Degree in healthcare or a related field - Deep understanding of medical billing codes (ICD-10, CPT) and healthcare billing regulations - Extensive experience in hospital billing operations, including revenue cycle management - Strong leadership and supervisory skills to manage a billing team - Excellent analytical and problem-solving abilities to identify and resolve billing issues - Proficiency in electronic health records (EHR) systems and billing software - Strong communication and interpersonal skills to collaborate with various stakeholders
PHYSICAL REQUIREMENTS: Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste. chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting patient care/handling injuries, radiation, shift work, travel may be required, use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
