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The Crossroads Center · 1 day ago

Billing Manager

Cincinnati, OH, US

Full-time

Onsite

Mid, Senior Level

5+ years exp

The Crossroads Center is seeking a Billing Manager to oversee the entire billing process related to client service delivery. This role includes managing billing staff, ensuring accurate invoicing, optimizing revenue cycles, and maintaining compliance while providing excellent customer service.

Health CareNon ProfitNursing and Residential CareRehabilitationTherapeutics

Responsibilities

Oversee the operations of the billing department, encompassing claims submission, payment posting, accounts receivable follow-up, collections, and reimbursement management; monitor billing policies and procedures, and workflows for efficiency and accuracy

Responsible for monitoring Behavioral Health Billing Solutions, LLC (BHBS) deliverables under the current contract and scope of work

Serve as the practice expert and go to person for all coding and billing processes

Ensure that all data entered into the EMR systems goes through desk review procedures before submission to funders for payment; responsible for updating and maintaining these procedures to meet the needs of the Agency

Maintain contacts with other departments to obtain and analyze additional client information to document and process billings

Analyze billing and claims for accuracy and completeness, follow-up with billers on work queues or pending claims, and ensure claims are submitted in a timely manner, received, and processed by payers

Prepare and analyze accounts receivable reports and insurance contracts with the Chief Financial Officer (CFO). Collect and compile accurate statistical reports

Document and track billing denials. Develop an action plan to address the denials for expedient and timely resolution

Provide guidance to departmental staff to resolve issues related to billing errors, collections, and/or denial processing techniques

Review and secure CFO’s approval for billing refunds

Secure patient account data during compliance reporting to Agency Finance and funders in the most efficient manner possible and in accordance with HIPAA rules

Audit current procedures to monitor and improve efficiency of billing according to County Board and other funders’ standards, insurance regulations, and according to first party payment policies established by the Agency

Oversee Cash Receipts process according to Agency policy

Responsible for payment posting of electronic and paper remittance advices (RAs) to EMR systems, reconciling payments to billing in EMR systems, and managing accounts receivables

Ensure clients’ financial entitlements are accurate and up to date

Recruit, train, supervise, and motivate department staff

Responsible for the direction and productivity of all department staff according to job descriptions and standards outlined in performance expectations

Analyzes trends impacting charges, coding, collection, and accounts receivable, and takes appropriate action to realign staff and revise policies and procedures

Meets regularly with the Chief Financial Officer to discuss the status of work and management matters related to the department

Responsible for maintaining and reporting all billing statistics for The Crossroads Center

Serve as the first escalation for problem accounts and customer service complaints related to billing

Communicate with providers, clients, and health plan personnel to solve difficult billing issues

Responsible for providing summary back-up reports for claims paid, showing client assigned program, funding source, and service period by month

Maintain a library of information/tools related to documentation guidelines and coding

Oversee the clinician credentialing process and ensure that it is accurate and timely

BHBS Perform clinician credentialing actions

Attend webinars and seminars to keep up on Medicaid, Medicare, and insurance changes

Keep up to date with all funders’ rule changes and distribute the information within the organization as warranted

Other duties as assigned

Qualification

Billing experienceMedical billing knowledgeRevenue cycle managementCertified billerManagement experienceEHR software knowledgeLeadership capabilitiesFinancial acumenBusiness office skillsExcelCPTICD-9ICD-10HIPAAInsurance regulationsCommunication skillsNegotiation skillsAttention to detailTeamwork skillsProblem solving

Required

Billing experience required

Bachelor's degree, preferably in business administration or related field; or associate's degree, preferably in business administration or related field and at least 5 years of healthcare experience

Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicaid and Medicare; strong knowledge of Ohio, Hamilton County and Federal payer regulations

Certified biller

Management experience required

Strong leadership capabilities

Financial acumen

Business office skills

Excellent verbal and written communication skills; skills in speaking with persons of various social, cultural, economic and educational backgrounds

Excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a behavioral health care setting

Capable of working independently, performing non-routine functions and problem solving

Working knowledge of CPT, ICD-9 and ICD-10 codes, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes

Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers

Able to demonstrate attention to detail, good teamwork skills and have the ability to prioritize and to meet deadlines

Expertise in Excel required

Ability to define problems, collect data, establish facts, and draw valid conclusions