Manager - PFS Billing - Hybrid AZ Residents Only

Kingman Regional Medical Center•Kingman, AZ

7d•Hybrid

About The Position

The CBO Billing Manager is responsible for the timely and accurate billing of all hospital and clinic government and commercial insurance and third-party payer claims. This role supervises and coordinates the activities of personnel in the billing department, credentialing, and clinic referrals. The Manager also oversees the maintenance of records, files, and reports in accordance with KHI standards and ensures that KHI Health Information Systems are operating appropriately in relation to billing, credentialing, and clinic referrals.

Requirements

High School Diploma or Equivalent
Five (5) years’ experience in all types of (healthcare) insurance billing including electronic transmission of claims
One (1) year supervisory experience
Manages staff through positive reinforcement that motivates and instills confidence
Typing and computer experience
Verbal and numerical intelligence
Ability to interact with the public
Ability to motivate people and utilize resources in an organized manner
Understanding of Medicare reimbursement

Nice To Haves

Bachelor degree in business or related field
Experience preferably in a hospital or similar institution

Responsibilities

Regularly directs the work of two or more full-time employees, with authority to hire, fire, and counsel staff.
Interviews and selects personnel, recommends promotion, disciplinary action, and termination of employees as needed, and handles employee complaints and grievances.
Keeps billers current on all changes of CPT4, ICD9, and HPCS codes to ensure correct claim payments; notifies credit personnel of invalid insurance or coverage limitations; investigates and resolves billing discrepancies; provides back-up billing assistance.
Works closely with other Department Managers on issues affecting other departments.
Plans, organizes, coordinates, and controls the systems for patient billing, provider credentialing, and clinic referrals information development, processing, and maintenance.
Monitors and evaluates the quality of the department and takes appropriate action based on findings.
Develops and revises job descriptions for all department positions; interviews, selects, and hires new or replacement staff.
Effectively utilizes employee improvement and corrective action methods; schedules work hours and assignments to meet customer needs; administers hospital and department policies and procedures; completes employee appraisals.
Provides opportunities for self and staff development through orientation, education, and training; maintains professional qualifications and stays informed of current developments and trends in billing and reimbursement processes.
Provides/coordinates community and education programs as needed; responds to physician requests and Medical Staff personnel.
Assesses current volumes and projects/plans for future service needs; establishes operational goals and objectives; evaluates achievements annually.
Randomly audits billing, credentialing, and referrals using sampling techniques to ensure accuracy; coaches employees for improvement; ensures insurance requirements and authorizations are obtained and effective; deals with insurance company provider representatives on cash flow issues.
Develops and implements policies and procedures for the department.