The Manager of Physician Billing is responsible for leading the departmental staff and developing, interpreting, setting and enforcing policies and procedures for the department. Address challenging customers and adverse situations that are escalated for resolution. Keep accurate and up to date information on policies and claim submission procedures for all participating insurance carriers and for sharing this information with other departments. Initiate and develop quality improvement teams to work independently to improve the work environment and develop training programs to update customers. EDUCATION AND EXPERIENCE REQUIREMENTS: Education: + High School Diploma or Equivalent required. Associate’s degree preferred. Experience: + 5 years of experience in the healthcare industry with hospital, physician practice or insurance coding, and billing and accounts receivable experience required (7-10 years of experience preferred) + Must be knowledgeable with healthcare billing practices and guidelines, claim submission procedures, and government/payer regulations. + Basic accounting skills required. ICD-9 and CPT coding, and NCQA credentialing standards for provider enrollment is required. Compete understanding of Skilled experience and knowledge of Window’s-based software required, including but not limited to Microsoft Windows, Excel and Word. Experience with Siemens Soarian systems and Allscripts electronic health record preferred. Certification: n/a RESPONSIBILITIES OF THE POSITION: + Responsible for the oversight and leadership of the Physician Billing Office staff. + Handles challenging customers, patients, insurance companies, other healthcare providers, physicians and adverse situations, in a professional and courteous manner, in which staff is unable to resolve. + Coordinate with various departments for resolution of operational issues. + Update various departments of procedural changes with insurance carriers that may impact workflow and to provide assistance in improving work flow. + Collaborate with staff and third party insurers to make certain that all claims are billed appropriately and all information required for payment is obtained by the staff prior to submission. + Ensures Primary claims are processes in 72 hours of being entered in the system and all secondary claims processed within 72 hours after the primary insurance payment is posted. + Continue to improve the way claims are processed and the timeliness. + Monitor and report on the cash collection productivity of the various components of the Physician Billing accounts receivable process. + Input data each month to produce spreadsheets and graphs to review and analyze the monthly accounts and dollars taken in to keep the accounts receivable days within acceptable levels. + Review and maintain all documentation required by our auditing staff or provider contracts. Maintain records of all payments for 7 years. + Participate in special purpose internal and external audits to ensure positive interdepartmental and auditor relations, assist with cost analysis studies, and present all required information in a timely and accurate manner. + Prepare ADHOC and Intellect reports, analyze data on aged accounts and takes appropriate action to resolve any discrepancies. Periodically audits individual account detail for each staff member to ensure complains. + Monitor the receivable management workstation, worklist or target files to ensure completion on a weekly basis. Appropriate activity coding will be utilized to generate automated follow up lists. + Utilize billing and scrubber systems including but not limited to Signature, Soarian Financials, Omnipro, HDX, SSI, Code Correct, Microsoft Office, Windows software, DSS, and other systems. Assist staff with system related questions and training. + Coordinates with various departments for resolution of operational issues and provides updates regarding procedural changes with insurance carriers that may impact workflow. + Responsible for keeping accurate and up to date information on the policies and claim submission procedures for all participating insurance carriers and for sharing this information with other hospital departments; HIM 10, Bulletins, Contracts, CPT-4, ICD-9 revisions. + Responsible for developing, interpreting, setting and enforcing policies and procedures for the department. + Participate on initiatives to enhance the work environment, team building, and develop training programs to educate the staff. Attend required training. + Provide oversight for overall recruitment, talent retention, performance management, staff and professional development, career advancement, disciplinary actions, employee training, etc. Conducts performance reviews, High-Middle-Low assessments, and recommends salary adjustments. + Demonstrate strong supervisory, leadership, communication, management and coaching skills, adhere to the Making Ellis Exceptional Standards, and initiate, promote, and support change initiatives. + Adhere to patient privacy policies and procedures, maintain confidentiality. + Adheres and ensures staff adheres to the legal, safety, health, fire, and sanitation codes, by being familiar with fire, safety, and disaster plans. + Other duties as assigned. Ellis Medicine is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex/gender, age, national origin, disability, genetic information, predisposition or carrier status, military or veteran status, prior arrest, or conviction record, marital or familial status, sexual orientation, transgender status, gender identity, gender expression, reproductive health decisions, or domestic violence victim status. Salary Range: $29.44-44.16 /hour Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.