Position Summary:
Manages and supports the operations of the Physician's Organization (PO) professional billing and collection functions related to assigned Foundations or Departments. Collaborates with peers and PO Management in the development and implementation of policies and procedures for billing and collection activity.
Key Responsibilities:
- Manages day to day billing operations for assigned departments or foundations. Maintains a high performing team through effective management of supervisors to ensure staff receive appropriate levels of training in billing procedures and use of EPIC in order to ensure timely and accurate billing of physician services.
- Develops daily, weekly, and monthly work priorities for assigned supervisors and staff. Makes recommendations regarding disposition of accounts. Reviews billing reports, collections, and other information to ensure staff production and quality assurance metrics are being met. Identifies, communicates, and facilitates resolution of problems as necessary.
- Collaborates with peers, directors, and PO leadership to develop, write, and implement policies and procedures for the physician billing office. Maintains compliance with the hospital's billing policies and procedures.
- Analyzes billing procedures and works collaboratively with PO contracting department and quality staff regarding any necessary changes to workflows or procedures. Recommends and implements changes as necessary in response to changing payer requirements or clinical activities. Provides reporting and support to various initiatives as needed.
- Leads and maintains a billing department that is focused on patient satisfaction and efficient billing operations. Organizes logistics of office space, equipment and supplies. Establishes vendor relationships, contracts and operational procedures for clearinghouse functions, patient statement processing and collection efforts for responsible parties.
- Stays current with changes in billing requirements and uses this knowledge to develop or modify policies and procedures for billing office. Participates in design and execution of training programs to assist billing staff to respond appropriately to billing inquiries. Works with PO management, foundation chiefs and department administrators to resolve program specific problems.
- Maintains contact with representatives from third party payers. Monitors reimbursement changes and trends. Interacts with other billing managers, the hospital's office for managed care and patient financial services. Attends meetings, both internal and external, as directed by PO management.
Minimum Qualifications
Education:
- Bachelor's Degree. Six years' of additional experience in progressively responsible positions with prior direct report responsibility or oversight within a physician or hospital billing office may be substituted for post-high school education.
Experience:
- Three years of revenue cycle experience including significant experience within the health insurance revenue cycle experience.
- Cardiology and/or Behavioral Health professional billing experience preferred.
- Previous experience managing large teams (10+ employees) preferred.
- Analytical skills necessary to plan for design or enhance billing systems and programs.
- State of the art awareness of billing requirements and technology related to physician billing to resolve problems.
- Ability to effectively manage the employees within assigned unit/department and to persuade and negotiate with peer level managers and superiors on issues and programs that impact assigned department.