Billing Manager

The Billing Manager is responsible for overseeing the billing processes related to elder care services. This includes managing the billing cycle for Medicaid, Medicare, private insurance, and private pay clients, ensuring compliance with regulatory requirements, resolving billing issues, and maintaining accurate financial records. The ideal candidate will have experience in healthcare billing, particularly in long-term care or elder services, and a strong understanding of relevant regulations and procedures.Key Responsibilities:

Billing Operations:

• Oversee the daily billing process for services provided to elderly clients, ensuring that all charges are entered correctly and timely.
• Manage the submission of claims to Medicare, Medicaid, private insurers, and private pay clients.
• Review, update, and maintain billing codes in accordance with applicable regulations and payer requirements.
• Monitor and ensure accurate and timely submission of claims, with a focus on minimizing denials or payment delays.

Compliance & Regulatory Adherence:

• Ensure all billing processes comply with local, state, and federal regulations, including Medicare and Medicaid rules and guidelines.
• Stay updated on changes in healthcare billing codes (CPT, ICD-10) and policies affecting elder care services.
• Ensure compliance with all documentation requirements for audits, reviews, and payer reviews.

Accounts Receivable Management:

• Monitor and track accounts receivable to ensure timely payment and follow up on outstanding balances.
• Work with clients, families, and insurance companies to resolve billing disputes and discrepancies.
• Perform regular reconciliation of accounts and follow up on overdue payments.

Team Leadership & Collaboration:

• Supervise and train billing department staff to ensure efficiency and accuracy in billing processes.
• Provide guidance and support to the team in handling complex billing issues, including denied claims and appeals.
• Collaborate with other departments (care management, finance, administration) to resolve billing-related issues and improve service delivery.

Reporting & Analysis:

• Prepare and analyze regular billing reports, including aging reports and revenue cycle metrics.
• Provide insights to management regarding trends in billing, reimbursement rates, and potential areas of improvement.
• Assist with budgeting and forecasting related to revenue and billing projections.

Customer Service:

• Provide excellent customer service to clients, families, and insurance companies, addressing questions related to billing statements, payment options, and insurance coverage.
• Resolve client complaints or issues regarding billing in a timely and professional manner.

Billing System Management:

• Ensure that the organization's billing software and systems are functioning effectively and efficiently.
• Work closely with IT or the software vendor to troubleshoot technical issues related to billing systems.

Qualifications:

• Education:
  • Bachelor's degree in accounting, finance, business administration, or related field preferred. Equivalent work experience may be considered in lieu of degree.
• Experience:
  • Minimum of 3-5 years of experience in healthcare billing, with a focus on elder services, long-term care, or home health preferred.
  • In-depth knowledge of Medicare, Medicaid, and private insurance billing.
  • Familiarity with CPT, ICD-10 codes, and HCPCS codes.
  • Experience with electronic billing systems and healthcare management software.
• Skills and Abilities:
  • Strong understanding of billing and coding practices, reimbursement methods, and payer policies.
  • Excellent problem-solving and analytical skills.
  • Detail-oriented with the ability to handle multiple tasks simultaneously.
  • Strong communication skills, both written and verbal.
  • Ability to lead and motivate a team.
  • Knowledge of applicable laws, rules, and regulations in the healthcare industry, particularly as they relate to elder services.
• Certifications (Preferred):
  • Certified Professional Coder (CPC), Certified Billing and Coding Specialist (CBCS), or other relevant certifications are a plus.

Compensation: $85,000-$95,000 a year
Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.