Corporate Billing Manager

Optalis Healthcare•Novi, MI

20h

About The Position

Overview The Corporate Billing Specialist accurately bills payers to assure timely payments of services provided, follows up on unpaid claims and audits accounts as necessary to resolve balances. Additionally, the Corporate Billing Specialist will provide assistance to the Corporate Billing Manager or Billing Team Lead as requested. Qualifications Education or experience with accounting functions, including accounts payable, billing, accounts receivable, collections, and bank reconciliations. A degree is preferred but not required with significant relevant experience. Specialized training in Medicare and Insurance billing preferred At least two years long term care billing experience Working knowledge of third-party insurers Working knowledge of the department of Health and Human Services Understands and has worked with Availity and similar Insurance portals Understands process of Medicaid Applications Understands how to determine Medicare Eligibility Understands Michigan MI Health Link Experience with collection calls and follow up documentation. Strong organizational skills, including managing the outcomes of others, and the ability to effectively multitask. Possesses strong interpersonal skills, including communication with supervisors, other staff and managers in the facility, vendors, and effective communication with residents and family members. Ability to effectively manage outcomes of this position as well as the outcomes of others in an environment of accountability. Effective user of technology, including personal computer and software applications in job functions. Examples include Microsoft Outlook, Email, Word, Excel, Internet, and use of billing and accounting software. Supervisor: Corporate Billing Manager Essential Functions and Responsibilities To perform this job successfully, an individual must be able to perform each key function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions. Responsibility The Corporate Billing Specialist will be responsible for maintaining the following: Responsible for billing and collections of assigned payers and all follow up on outstanding collections. Understand the terms of managed care/hospice (BCBS 5 th Level and Medicaid) contracts and bills in accordance with these terms. Review admissions weekly to assure data is properly inputted in the accounting system for proper billing. Follow up with facilities if data is missing regarding Admission Contracts, Insurance/Medicaid/Medicare numbers, LOCDs, PASAARs, etc. Sends out a weekly report to facility Business Office Managers, Regional Business Office Manager and key facility team members, if applicable, for follow-up of any missing information required to successfully bill claims and obtain payment. Follows up daily on outstanding receivables and responds to requests for information and denials in a timely manner. Maintains up to date knowledge of how to bill ALL commercial insurances, managed care, Medicare PPO, HMO, advantage plans, auto claims, worker’s compensation claims, Medicaid HMO and managed Medicaid plans. Accurately bills coinsurance and copay amounts; adjust account balances in accounting system appropriately. Addresses and is able to explain Explanations of Benefits, co-pays and deductibles. Completes month end processes timely. Report facility level barriers to Billing Team Lead. Effectively manages time to meet deadlines. Direct involvement in accounts receivable collections process, including responsibility for pursuit of delinquent accounts. Responsibility for completing external reports for third parties as assigned. Participation in relevant in-service training sessions. Attendance and participation in relevant meetings Willingness to perform other duties as assigned, including various clerical duties as they are necessary. Leadership: demonstrates willingness to take risks, generates new ideas for change; evaluates and recognizes priorities, select effective team members, challenges others to learn, keeps current and integrates new information, communicates and models organization values, fosters high performance, recognizes need for and provides adequate resources. Process Improvement: Applies PI principles, tools, and techniques; assists in data collections; identifies processes for improvement in daily work; educates new staff in team process. Process Improvement: Demonstrates active listening techniques; gains support through effective relationships; treats others with dignity and respect; seeks feedback; sets clear standards for performance; evaluates job performance and provides effective feedback; establishes systems to measure effectiveness, efficiency, and service; creates and maintains reporting mechanisms. Continuing Education: Attends in-service and education programs; attends continuing education required for maintenance of professional certification or licensure. Physical Demands: The physical demands described here are representative those that must be met by an employee to successfully perform the essential functions of the job. While performing the duties of this job, the employee is frequently required to stand and walk. The employee is occasionally required to sit for long periods of time completing work on the computer; reach with hands and arms; and talk or hear. Occasional physical effort with light to medium objects. Occasionally required to lift objects of 10 to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

Requirements

Education or experience with accounting functions, including accounts payable, billing, accounts receivable, collections, and bank reconciliations.
Specialized training in Medicare and Insurance billing preferred
At least two years long term care billing experience
Working knowledge of third-party insurers
Working knowledge of the department of Health and Human Services
Understands and has worked with Availity and similar Insurance portals
Understands process of Medicaid Applications
Understands how to determine Medicare Eligibility
Understands Michigan MI Health Link
Experience with collection calls and follow up documentation.
Strong organizational skills, including managing the outcomes of others, and the ability to effectively multitask.
Possesses strong interpersonal skills, including communication with supervisors, other staff and managers in the facility, vendors, and effective communication with residents and family members.
Ability to effectively manage outcomes of this position as well as the outcomes of others in an environment of accountability.
Effective user of technology, including personal computer and software applications in job functions. Examples include Microsoft Outlook, Email, Word, Excel, Internet, and use of billing and accounting software.

Nice To Haves

A degree is preferred but not required with significant relevant experience

Responsibilities

Responsible for billing and collections of assigned payers and all follow up on outstanding collections.
Understand the terms of managed care/hospice (BCBS 5 th Level and Medicaid) contracts and bills in accordance with these terms.
Review admissions weekly to assure data is properly inputted in the accounting system for proper billing.
Follow up with facilities if data is missing regarding Admission Contracts, Insurance/Medicaid/Medicare numbers, LOCDs, PASAARs, etc.
Sends out a weekly report to facility Business Office Managers, Regional Business Office Manager and key facility team members, if applicable, for follow-up of any missing information required to successfully bill claims and obtain payment.
Follows up daily on outstanding receivables and responds to requests for information and denials in a timely manner.
Maintains up to date knowledge of how to bill ALL commercial insurances, managed care, Medicare PPO, HMO, advantage plans, auto claims, worker’s compensation claims, Medicaid HMO and managed Medicaid plans.
Accurately bills coinsurance and copay amounts; adjust account balances in accounting system appropriately.
Addresses and is able to explain Explanations of Benefits, co-pays and deductibles.
Completes month end processes timely.
Report facility level barriers to Billing Team Lead.
Effectively manages time to meet deadlines.
Direct involvement in accounts receivable collections process, including responsibility for pursuit of delinquent accounts.
Responsibility for completing external reports for third parties as assigned.
Participation in relevant in-service training sessions.
Attendance and participation in relevant meetings
Willingness to perform other duties as assigned, including various clerical duties as they are necessary.
demonstrates willingness to take risks, generates new ideas for change; evaluates and recognizes priorities, select effective team members, challenges others to learn, keeps current and integrates new information, communicates and models organization values, fosters high performance, recognizes need for and provides adequate resources.
Applies PI principles, tools, and techniques; assists in data collections; identifies processes for improvement in daily work; educates new staff in team process.
Demonstrates active listening techniques; gains support through effective relationships; treats others with dignity and respect; seeks feedback; sets clear standards for performance; evaluates job performance and provides effective feedback; establishes systems to measure effectiveness, efficiency, and service; creates and maintains reporting mechanisms.
Attends in-service and education programs; attends continuing education required for maintenance of professional certification or licensure.