Overview
Billing Manager – Healthcare $60-70k Salary — Supervise 4-5 billing specialist
Leominster, MA
Description
Essential Duties and Responsibilities:
· Prepares and analyzes billing office financial reports in a timely manner
· Setting up, maintaining, and reconciling all EDI transmissions received and transmitted out of the NextGen system
· Setting up EDI customer profiles by determining electronic capabilities with external customers
· Maintaining supporting documentation for all billed invoices
· Ensuring all payments are posted timely
· Researching, escalating and resolving any billing discrepancies
· Ensuring that claims are filed accurately and within the time limits required for each payer
· Working with payers to resolve outstanding claim processing issues
· Addressing and resolving account credit balances on a weekly basis
· Researching, escalating and resolving any denied claims either identified from aged accounts reports or payer remittances within required filing time limits
· Tracking incoming EDI file names, dates, claim counts, and fatal edits, including logged, run and process files
· Maintaining and updating mapping setups to support trading partners profiles
· Communicating with internal departments, as well as contracted providers, concerning submittal issues that require troubleshooting
· Providing feedback to internal departments about issues on the front end that are impacting the department
· Responsible for managing CHC’s relationship with Clearinghouse vendors as well as with the various insurance companies (i.e. Medicaid, Medicare, HSN)
· Ensuring that the NextGen system is updated with the correct fee schedules and contractual allowances
· Monitoring all changes in fees with the various payers and ensuring the system is updated timely
· Resolving of any collections issues for self-pay balances as needed
· Overseeing the credentialing process and staff to ensure this function is performed timely and accurately
· Managing accounts receivable weekly by reviewing aging/collections reports and ensuring claims are being resolved or written off timely
· Overseeing the month-end process by ensuring that all transactions necessary for the given month are completed timely
· Identifying and processing any requests for system changes
· Demonstrating an understanding and commitment of the health center mission
· Demonstrating an understanding and commitment to the established CHC Values and Standards
· Performing all other duties as assigned by supervisor
Minimum Qualifications:
· 5- 7+ years of experience in medical third party billing environment dealing with both billing and
· Experience with Electronic Data Processing (EDI).
· The individual needs to have solid EDI experience – comfortable with queries, loading files, working on issues with IT and other
· The individual should be familiar with IDC10 and CPT Coding and a CPC is a plus. NextGen experience
Qualifications
Goal Completion: Inspired to perform well by the completion of tasks
Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
if interested and qualified, e-mail resume at once to douglas@alexanderbec.com