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 complies with established policies, procedures, and internal controls. This hands-on leadership role requires hospital billing and reconciliation experience and familiarity with hospital patient accounting systems, including Epic and MEDITECH Magic and 6.x/Expanse environments. The manager leads staff and supports training, billing, cash posting, collections, compliance, and reporting. The role manages billing operations and account follow-up, monitors productivity and key performance indicators, supports accurate coding and reimbursement, resolves payer and system issues, and ensures required reporting and compliance activities are completed.

Requirements

Bachelor’s degree and a minimum of seven years of prior relevant experience; relevant experience may substitute for formal education or an advanced degree.
Five years of healthcare revenue cycle and hospital billing experience.
Experience with Epic, MEDITECH Magic, and/or MEDITECH 6.x/Expanse.
At least two years of people management experience within the seven years of relevant experience.
Strong hospital billing and reconciliation experience.
Strong critical-thinking skills and strong accounts receivable acumen.
Ability to make sound judgments and quick decisions.
Experience driving cash and accounts receivable account resolution and working with payers.
Ability to understand and manage client service-level metrics and revenue cycle performance indicators.

Nice To Haves

Solid understanding of healthcare revenue cycle.
Demonstrated competency working in teams and ability to communicate effectively with all levels.

Responsibilities

Lead and manage staff in a manner that fosters trust, teamwork, communication, and improvement; provide feedback, tools, and opportunities for relevant training.
Ensure employees understand applicable State and Federal rules and regulations, compliance requirements, and procedures for reporting compliance issues.
Manage billing, cash posting, collections, and follow-up on third-party and self-pay accounts after initial billing.
Drive cash collection and accounts receivable resolution, working with payers and escalating issues as needed.
Manage expected reimbursement variances and work with departments to ensure CPT-4, HCPCS, and revenue codes are accurate.
Provide departments with Medicare and other payer updates, notices, and coverage changes affecting billing and reimbursement.
Review processes and systems to maintain effective methods for meeting departmental and facility goals; coordinate with IT on changes needed to maintain billing accuracy.
Ensure electronic bill holds meet established goals and resolve billing and cash-posting issues with electronic billing vendors and payers.
Identify and resolve patient accounts receivable process problems; initiate changes as appropriate to address payer issues, underpayments, and denials.
Review and approve account credit arrangements, refunds, write-offs, and adjustments, ensuring compliance with departmental and medical center approval policies.
Prepare, distribute, and present required daily, weekly, and monthly reports; monitor department performance and productivity and ensure reports are completed on time.
Serve as a technical resource on Medicare regulations and reimbursement; ensure Medicare Bad Debt Log components and supporting documentation are complete and oversee Bad Debt vendor reconciliation.
Inform management of compliance issues and attend pertinent internal and external seminars, sharing relevant information with staff and other departments.
Complete assigned special projects within established timeframes and document account work in the patient accounting system.
Ensure established goals are met; develop and execute projects to reduce aged accounts receivable and improve collections.
Manage client service-level metrics and revenue cycle performance indicators, and develop and follow methods for KPI improvement.
Maintain weekly Key Indicator Reports, daily Patient Accounting and Billing Scrubber reports to departments, departmental claim hold logs, daily electronic and paper claim reports, and other reports requested by management.
Review and maintain JACHO requirements for billing, cash posting, and collections.