Manager, Billing and Coding - Sleep Medicine - Ohio Sleep Medicine Institute

Vituity•Columbus, OH

14h•Onsite

About The Position

As Manager, Billing and Coding, you play a vital role in our mission to improve lives. Lead and oversee the professional and/or facility billing and revenue cycle operations for the sleep medicine practice. At Vituity we know the impact you can have. Join the Vituity Team. At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done. Vituity Locations: Vituity has opportunities at 900 practices across the country, serving 14.5+ million patients a year. With Vituity, if you ever need to move, you can take your job with you.

Requirements

Minimum of five years of experience in medical billing or revenue cycle, including at least two years in a lead or supervisory role required.
Proficiency in medical terminology and coding systems (ICD-10, CPT, DRG) and billing software required.
Demonstrated knowledge of revenue cycle management, payer requirements, and medical collection practices and procedures required.
High school diploma or equivalent required.
Certified Professional Coder (CPC) or Certified Professional Biller (CPB) certification required, or an Associate's or Bachelor's degree in healthcare administration, business, or a related field.
Strong leadership, coaching, and team management skills.
Ability to develop and deliver coding and billing education to providers and staff.
Knowledge of medical collection practices and procedures.
Strong attention to detail and accuracy in coding and billing processes.
Excellent written and verbal communication skills to interact with patients, insurance companies, providers, and staff.
Ability to analyze data, monitor performance, and drive process improvement.
Ability to work independently, prioritize, and manage multiple priorities in a fast-paced environment while upholding HIPAA regulations.
Ability to interpret payer contracts and identify compliance or reimbursement violations requiring escalation.

Nice To Haves

Experience with sleep medicine, pulmonary, or related specialty billing preferred.
Prior experience overseeing revenue cycle operations in a multi-provider or multi-specialty outpatient practice preferred.

Responsibilities

Supervise, train, schedule, and develop billing team staff, establishing clear productivity and quality standards and providing ongoing coaching and feedback.
Oversee the day-to-day billing and revenue cycle operations for the sleep medicine practice to ensure accurate and timely billing of professional and/or facility services.
Establish, monitor, and report on key performance indicators (KPIs) for billing, coding, collections, and accounts receivable.
Serve as the escalation point for complex billing issues, payer disputes, and patient billing inquiries.
Develop, document, and maintain billing workflows, policies, and standard operating procedures to promote consistency and efficiency.
Partner with the medical director, providers, and practice leadership to align billing operations with organizational goals.
Review Accounts Receivable and Collection Write-Off Reports and approve appropriate action, including establishing payment plans or referring accounts to a collection agency.
Oversee the review and analysis of medical records and documentation to ensure accurate coding and billing.
Ensure appropriate assignment of ICD-10, CPT, and DRG codes for sleep studies (e.g., polysomnography, home sleep apnea testing, MSLT, MWT) and related services.
Audit charges and coding for accuracy, completeness, and compliance, and provide education and feedback to staff and providers.
Oversee verification of patient insurance coverage and completion of required prior authorizations for sleep medicine services.
Ensure timely and accurate preparation and submission of claims to insurance companies for reimbursement.
Perform and oversee pre-verifications with insurance companies to determine where to send the claim, via phone or by running online eligibility.
Monitor payer policies, sleep medicine coverage criteria, and regulatory changes, and update billing processes accordingly.
Oversee follow-up on unpaid or denied claims and the resolution of billing discrepancies to maximize reimbursement.
Direct the application of medical collection practices and procedures in accordance with payer and regulatory requirements.
Apply critical thinking to determine when a payer is in violation of contract terms or a legal obligation to pay, and pursue appropriate resolution.
Ensure compliance with HIPAA, payer contracts, and organizational policies, and promptly report and address suspected compliance concerns.
Maintain the confidentiality of patient information in accordance with HIPAA regulations and Privacy Policies regarding PHI.
Prepare and present billing, collections, and revenue cycle performance reports to practice and medical leadership.
Collaborate with practice staff and providers to ensure accurate and timely billing processes across the sleep medicine practice.
Identify and implement opportunities for process improvement, automation, and staff development.

Benefits

Superior health plan options
Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6% plus discretionary profit-sharing contributions (eligible January following 18 months of service)
Outstanding Paid Time Off: Start at 4 weeks’ PTO, Paid holidays, Sabbatical
Student Loan Refinancing Discounts
Professional and Career Development Program
EAP and travel assistance included
Wellness program
Commuter Benefits Program
Purpose-driven culture focused on improving the lives of our patients, communities, and employees