Billing & Collections Manager

POSITION SUMMARY

Responsible for knowing, understanding, and following insurance billing regulations for non-Emergency and Emergency Ambulance billing. Running and providing Department reports for monitoring purposes.

Completing and maintaining projects assigned for any Department category - Medicare/Medicaid, Facility, Billing, PT Collections.

KEY RESPONSIBILITIES

• Responsible for ALL aspects of Billing and Collections for 911 and non-Emergency Ambulance Service provider such as: verifying insurance eligibility, obtaining authorizations, billing patients, hospitals, insurance companies, Medicare, Medicaid, No-Fault and Worker's Compensation claims insurance denials, collecting on past due accounts.
• Liaison between senior management, employees, and clients to ensure proper lines of communication. Crucial step in addressing a myriad of problems and issues requiring immediate attention and resolve.
• Provide general administrative and clerical support including but not limited to: receiving and sorting daily mail, maintaining medical records, faxing, copying, scanning and stamping outgoing mail.
• Responsible for training and coaching team members on new and/or existing procedures.
• Work closely with several outside collection agencies to ensure accurate handling of patient accounts.
• Responsible for daily, weekly, and monthly reporting of the following reports: department productivity, QA/Ql's, Collection Agency Payments, Stipends, Medicare/Medicaid Daily Billings & payment schedule, Collection Agency assignments, uploads and payment reporting, Waystar rejections. Pt/Ins submission confirmations, VAC's collection follow ups, ALS intercepts, M911 Billing audits, and Volume reports.
• Attending industry Webinars/ Conferences and preparing summary to ensure we are up to date with industry & billing compliance standards.
• Responsible for payer enrollment via Waystar.
• Responsible for identifying insurance payers that submit payments manually and enrolling them in ACH to expedite receipt.
• Responsible for completing department projects as assigned.
• Work closely with Department Managers/ Supervisors to create improvement, implement processes to ensure department goals and objectives are met on a consistent basis.

POSITIONQUALIFICATIONS

Education&Experience

• High School Diploma. Associate degree preferred.
• Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC) preferred.
• Extensive Medicare and Medicaid experience and understanding medical necessity in ambulance transportation.
• Ambulance/ Medical billing certification or diploma preferred.
• Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR's and all forms of medical billing (direct, 3rd party, HMO's, private pay, no-fault, Worker's Compensation, Medicare & Medicaid.
• Excellent organizational skills and the ability to multi-task in a fast-paced environment.
• Review and research data. Utilize intuition and experience to compliment data.
• Thorough knowledge of transport documentation (PCRs).
• Ability to follow up on outstanding Medicare accounts.
• Ability to submit appeals and overpayment requests.
• Familiar with Medicare/CMS requirements and guidelines.
• Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance.
• Excellent written and verbal communications skills required
• Excellent documentation skills (promptness, accuracy, thoroughness, and legibility).
• Credit and Collections Procedures, Payment Plan/ Settlements/ Collection Agency.
• MAS Medicaid Billing.
• PCS/ Medical necessity.
• Customer Service/ Client relations.
• Returned Mail/ Skip Tracing.

Competencies:

• Working knowledge of EMS systems, private ambulance, and medical transportation systems preferred.
• Knowledge of CONN EX preferred.
• Knowledge Microsoft Word, Microsoft Excel, and Microsoft Windows.
• Familiarity with medical terminology
• Organizational and leadership abilities, detail oriented.

Work Environment:

• Work is performed under normal working conditions within a standard office environment.

PhysicalRequirements:

• High level of sitting/working at a desk
• Light physical effort (lift/carry up to 10 lbs.)
• Must be able to perform the essential duties of the position with or without reasonable accommodations.