Billing Manager – Healthcare $60-70k Salary — Supervise 4-5 billing specialist

Leominster, MA


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


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