Billing Operations Manager

General Responsibilities:

The Billing Operations Manager coordinates all direct patient and third-party billing and reimbursement functions to ensure prompt payment of accounts and optimal reimbursement. The Billing Operations Manager recruits, hires, and promotes according to Brown EM's Affirmative Action and Equal Employment Opportunity Policies.

Required Qualifications:

• A minimum requirement of a bachelor's degree in business management, finance, healthcare administration, or related field with 5 years of relevant experience. In lieu of a degree, a high school diploma with 10 years of relevant experience is required.
• Current knowledge of ICD-10 and CPT-4 coding, billing, medical terminology, and compliance standards is preferred.
• Must have a proven record of good managerial and excellent customer services skills
• Ability to prioritize and organize a variety of tasks to support departmental needs
• Demonstrates ability to clearly communicate verbally and in written form
• Good computer skills required. Working knowledge of Microsoft Office, with proficiency in Microsoft Excel and Access required.
• Experience in Emergency Medicine billing is preferred.

Preferred Qualifications: Master's degree preferred.

Primary Contacts:

The Billing Operations Manager has daily contacts with supervisor, all Billing Department staff, patients and family members, Brown EM management, providers and other employees, interns/externs, insurance carrier representatives, auditors, vendors, and other community agencies.

Physical Effort / Environment:

Mild to moderate physical effort to perform basic clerical, typing, and filing duties. Some prolonged sitting. Minor lifting.

Work Schedule Demands:

Normally works a 40-hour week and the position generally requires the incumbent to be on the job daily.

Communication Skills:

Very good verbal communication, written communication, and analytical skills are required, as incumbent to most often speak with patients, medical providers, management staff, community resources, insurance carrier representatives, auditors, and other necessary providers. Ability to express thoughts clearly and in writing.

Confidentiality of Information:

This position requires a person with extreme diligence in protecting employee confidential information, including but not limited to: salary, bonus, Social Security numbers, leave of absence details, PHI, disciplinary or corrective actions, performance evaluations, and other details. Any questions about what information may be provided to others should be referred to the Chief Financial Officer of BPI or the President of Brown EM.

Significant Job Functions:

Billing

• Coordinates and oversees computer systems as they relate to patient billing, monthly closing and related functions; implements changes to systems as necessary.
• Responsible for month-end closings and for supervising and preparation of monthly and yearly computer reports.
• Oversees all billing policies, procedures, and practices
• Maintains current knowledge of patient reimbursement issues impacting upon Brown EM's billing operations.
• Deals with third-party payor representatives and provider services to solve large-scale billing issues.

Revenue Improvement

• Provides management and oversight of the physical sites for billing
• Works with administrative team to plan and develop business ventures, including but not limited to staffing, supplies, technologies, and operations
• Develop and implement controls on billing processes
• Maintains compliance with payor reimbursement policies and governmental regulations as well as Medicare/CMS guidelines.
• Develops and implements quality improvement indicators that accurately measure areas of recommended improvement and reports.
• Provide consultation and recommendations on escalations and on complex billing issues.
• Monitor department performance results through observation, audits, data analysis and operational reports. Develop new reporting measures and metrics as needed.
• Work with leadership team and others to ensure compliance with government and non-government payers' incentive-based and other quality measures' programs.
• Work closely with managers and leadership team to communicate information necessary to ensure processes are implemented and adhered to
• Responsible for overall planning and execution of revenue cycle operations and goals

Compliance

• Maintains compliance with payor reimbursement policies and governmental regulations as well as Medicare/CMS guidelines.
• Monitors progress resulting from periodic internal and external audits
• Assists with external auditors' requests, if needed

Management

• Provides current data for reports to the Chief Financial Officer as needed.
• Attends internal/external meetings/trainings related to areas of responsibility, when necessary.
• Attendance at various committee meetings as required.
• Meets with supervisor on a regular basis for supervision.

General

• Maintains a neat and orderly work area.
• The Billing Operations Manager must maintain professional behavior when interacting with staff members, patients, insurance carrier representatives, vendor, and others.

Other

• For Brown EM to run more efficiently, the Billing Operations Manager will be expected to do other tasks assigned at the discretion of the supervisor.

Evaluation of Performance:

The Billing Operations Manager is evaluated annually. Methods used to assess performance will include:

• How well an incumbent meets significant job functions and responsibilities.
• Attainment of established job-related developmental competency goals.
• Evaluations may be based on both department and individual work performance.

All requirements are subject to possible modification to reasonably accommodate individuals with disabilities. Some requirements may exclude individuals who pose a direct threat or significant risk to the health and safety of themselves or other employees.

This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instructions and to perform other job-related duties requested by their supervisor.

Requirements are representative of minimum levels of knowledge, skills and/or abilities. To perform this job successfully, the incumbent will possess the abilities or aptitudes to perform each duty proficiently.

This document does not create an employment contract, implied or otherwise, other than an "at-will" employment relationship.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Employees are required to be vaccinated against COVID as a condition of employment, subject to accommodation for medical exemptions.

EOE/F/M/Vet/Disabled