Healthcare Billing Manager Job at GOALS for Autism, Inc., Walnut Creek, CA

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  • GOALS for Autism, Inc.
  • Walnut Creek, CA

Job Description

Job Summary:

The Medical Billing Manager is a part-time position responsible for overseeing the billing coding staff and

responsible for understanding and coding all procedures within regulatory mandates; assists with following up on insurance claims, and submitting appeals as needed. This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure maximization of cash flow while improving client and practitioner relations. The Medical Billing Manager position requires the ability to produce and present detailed billing activity reports

Essential Role and Responsibilities:

  • Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
  • Serves as the practice expert and go to person for all coding and billing processes
  • Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection
  • Analyzes billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
  • Follow up on claims using various systems, i.e. practice management and clearinghouse
  • Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
  • Prepares and analyzes accounts receivable reports, and weekly and monthly financial reports in concert with the Practice Administrator and Operations Manager. Collects and compiles accurate statistical reports
  • Audits current procedures to monitor and improve efficiency of billing and collections operations
  • Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements
  • Participates in the development and implementation of operating policies and procedures
  • 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
  • Analyzes trends impacting charges, coding, collection, and accounts receivable and takes appropriate action to realign staff and revise policies and procedures with the approval of Operations Manager and/or Practice Administrator.
  • Keep up to date with carrier rule changes and distribute the information within the practice
  • Understands and remains updated with current coding and billing regulations and compliance requirements
  • Maintains library of information/tools related to documentation guidelines and coding
  • Supervises billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
  • 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
  • Coordinates team member time off in a manner that does not negatively impact necessary daily functions.
  • Other duties as assigned by the Operations Manager and/or Practice Administrator
  • Participates in Development survey once a month for a minimum of 3 people 
  • Ensures staff receive score cards and 1:1 reviews per company policy
 

General Responsibilities: 

  • Performs all duties and responsibilities in an efficient, team-oriented manner.
  • Accountable for being knowledgeable and understanding of all aspects of the billing and coding staff duties to include:
    • Verifying patient eligibility and benefits for upfront collection on unmet deductibles and co-insurance
    • Enter charges accurately according to insurance payers/contracts
    • Submitting clean claims by attaching necessary documentation for payment
    • Follow-up on electronic claims and paper claims
    • Posting insurance payments to patient accounts
    • Submit all secondary claims when necessary
    • Refund money owed to patient or insurances
  • Conducts self in a manner that reflects a positive representation of the company, and encourages others to do the same.
  • Observes strict patient confidentiality in dealing with patients.

Qualifications and Education Requirements:

  • Minimum 5 years experience billing in a healthcare setting
  • Computer Proficient and well versed in MS Office and Google Apps.
  • Customer Service skills are essential
  • Strong verbal and written communication skills.
  • Excellent management and leadership skills.
  • Highly detailed-oriented and organized
  • Capable of multitasking and handling difficult situations
 

Preferred :

  • Bachelor's Degree in Accounting, Finance, Healthcare administration, or similar field is preferred but not mandatory
 

Special Qualifications (Skills, Abilities, Licenses):

  • Sensitive to working with an ethnically, linguistically, culturally, and economically diverse population
  • Ability to multitask and handle large phone and email correspondence
  • Strong decision-making skills with the ability to self-motivate and function as part of a team
  • Able to exercise confidentiality and discretion pertaining to the work environment
  • Able to appropriately interpret and implement policies, procedures, and regulations
  • Able to obtain criminal record clearance through Department of Justice
  • Able to obtain a negative Tuberculosis test

Job Tags

Part time,

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