Manager, Hospital Billing

Guidehouse•San Antonio, TX

About The Position

The Hospital Billing Manager oversees daily billing functions for hospital and healthcare revenue cycle operations, ensuring billing follows established policies, procedures, and internal controls. The role requires hands-on leadership, strong hospital billing and reconciliation experience, sound critical thinking, and experience with hospital patient accounting systems, including Epic and MEDITECH Magic and 6.x/Expanse environments. The manager leads and trains staff, oversees billing, cash posting, collections, compliance, and reporting, and works with payers and internal departments to resolve accounts receivable issues. The position monitors performance and productivity, supports accurate billing and reimbursement, and develops improvements to reduce aged accounts receivable and enhance collections.

Requirements

Bachelor’s degree and a minimum of 7 years of prior relevant experience; relevant experience may substitute for formal education or an advanced degree.
5 years of healthcare revenue cycle and hospital billing experience.
Experience with Epic, MEDITECH Magic, and/or MEDITECH 6.x/Expanse.
At least 2 years of people management experience within the required 7 years of relevant experience.
Strong accounts receivable acumen, judgment, and ability to make timely decisions.
Ability to understand and ensure compliance with applicable state, federal, and HIPAA requirements.

Nice To Haves

Solid understanding of the healthcare revenue cycle.
Demonstrated ability to work effectively in teams and communicate with people at all levels.

Responsibilities

Lead in a manner that builds trust and teamwork, maintain open communication with staff and management, and encourage employee input on relevant policies and procedures.
Ensure employees understand applicable state and federal rules and regulations and have the tools and training needed to meet department goals.
Drive cash collection and accounts receivable resolution, working with payers to resolve and escalate issues.
Manage expected reimbursement variances and collaborate with departments to ensure CPT-4, HCPCS, and revenue code accuracy.
Provide departments with Medicare and other payer updates, notices, and coverage changes that affect billing and reimbursement.
Review billing processes and systems, collaborate with IT on changes, and ensure electronic bill holds meet established goals.
Work with electronic billing vendors and payers to resolve billing and cash-posting issues.
Identify and resolve patient accounts receivable process problems, including payer issues, underpayments, and denials, and initiate corrective changes when appropriate.
Review and approve credit arrangements, refunds, write-offs, and account adjustments, ensuring required approval levels and policies are followed.
Manage employees following up on third-party and self-pay accounts after initial billing.
Prepare, distribute, and present required daily, weekly, and monthly reports; monitor departmental performance and productivity and ensure timely reporting.
Serve as a technical resource for Medicare regulations and reimbursement, ensure Medicare Bad Debt Log documentation is complete, and oversee bad debt vendor reconciliation.
Communicate compliance issues to management and ensure staff understand compliance requirements and reporting procedures, including state, federal, and HIPAA requirements.
Attend relevant internal and external seminars and share information with staff and appropriate departments.
Review and maintain JACHO requirements for billing, cash posting, and collections.
Complete assigned special projects within their specified time frames and document each account worked in the patient accounting system.
Ensure established goals are met and develop and execute projects to reduce aged accounts receivable and improve collections.
Understand and manage client service-level metrics and revenue cycle performance indicators, and develop and follow methods for KPI improvement.
Prepare weekly key indicator reports, provide patient accounting and billing scrubber reports to departments daily, maintain departmental claim-hold logs, and prepare daily electronic and paper claim reports and other requested reports.