Medicaid Billing Manager

RKL LLP • Lancaster, PA

5d • $70,000 - $80,000

About The Position

The Medical Billing Manager oversees the firm’s full medical billing services team for a variety of clients within the post-acute healthcare industry, including nursing, retirement communities, home health, and hospice facilities. As team leader, the Medical Billing Manager is responsible for the training, mentorship and performance management of Medical Billing Specialists while ensuring high levels of customer satisfaction and the efficient resolution of claims. Success Factors Responsibilities Responsible for training Medical Billing Associates and Specialists on billing procedures and claim follow-up on the numerous systems clients utilize Establish collaborative working relationship with Medical Billing team to ensure all client needs are met Communicate and collaborate with new clients to ensure client needs can be met by the Medical Billing Team Organize new client work and distribute among team members Train team members to achieve a strong understanding of Medicare, Managed Care, and Medicaid regulatory billing practices Review claims against medical documentation provided by clients to ensure clean claims are submitted to the appropriate third party payer Communicate with Medical Billing Associates, Specialists and client when claims require additional information prior to submission Establish collaborative working relationship with clients as their main point of contact Stay abreast of current medical coding and billing issues, trends and changes in the laws and regulations in order to make recommendations for changes in policies and procedures Meeting monthly with Medical Billing Associates and Specialists to review aging reports in detail Assist Medical Billing Associates and Specialists in investigating, managing and resolving medical claims in accordance with established requirements and procedures Assist Medical Billing Specialists with troublesome accounts receivable balances, policy, or work flow questions Ensure timely and high quality service to meet and exceed client expectations and perform research on projects as needed Develop available resources and appropriate guidance and policies Organize facts, analyze and interpret information according to client circumstances Train team to process all payer types and various billings including no pay claims and bad debt while maintaining cost report logs Proficient in all main software systems used and ability to perform every function in those systems (including cash posting, ancillary posting, adjustments, claim troubleshooting) Act as day-to-day liaison between Medical Billing Team and In-Charge/Partner when staff require assistance Other duties as assigned People Management/Relationships Take initiative to be a team lead (proactively seek opportunities to help others) Treat everyone with respect Develop loyalty and trust within the team Successfully adapt to different personalities and working styles Proactively and effectively communicate information regarding status issues to team members Hold self and others accountable for assigned work; seek and provide continuous feedback to learn and develop in role; open to new ideas and suggestions Business Growth (if applicable) Possesses an understanding of RKL’s business (service lines, competitors) and client service capabilities and the impact of technology upon the firm’s growth and success Qualification To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Requirements

• Excellent organization skills and strong attention to detail
• Multitasker with the ability to prioritize work accordingly
• Excellent verbal and written communication skills with strong client service focus
• Strong analytical and interpersonal skills
• Ability to work autonomously under the pressure of tight deadlines and multiple priorities
• Ability to research and analyze data and resolve issues; read and interpret medical terminology
• High school diploma or equivalent (GED)
• 5+ years’ experience in Medicaid/insurance billing or related position required
• Previous management/supervisory experience preferred with ability to coach and train team members
• Experience navigating electronical and paper medical record systems
• Knowledge and understanding of insurance contracting, Medicare and Medicaid
• Strong knowledge of Microsoft Office suite products and technology-savvy individual
• Regularly required to perform manual tasks, concentrate, think, learn, communicate, sit, stand, walk, use hands and fingers, grasp, handle or feel objects, reach with arms, talk and hear
• Must be able to remain in a stationary position as needed
• The person in this position needs to occasionally move about inside the office and on site at client locations, stoop, kneel, crouch, push and pull
• Vision abilities required include close vision, distance vision and the ability to adjust focus.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer
• Ability to communicate in a professional manner and exchange information with internal and external actors as needed
• Ability to lift/carry up to 20 pounds
• Ability to work outside of normal business hours and weekends as needed
• Ability to travel to local and non-local clients and events as needed, overnight travel may be required

Nice To Haves

• Associate’s degree and medical billing certification preferred

Responsibilities

• Responsible for training Medical Billing Associates and Specialists on billing procedures and claim follow-up on the numerous systems clients utilize
• Establish collaborative working relationship with Medical Billing team to ensure all client needs are met
• Communicate and collaborate with new clients to ensure client needs can be met by the Medical Billing Team
• Organize new client work and distribute among team members
• Train team members to achieve a strong understanding of Medicare, Managed Care, and Medicaid regulatory billing practices
• Review claims against medical documentation provided by clients to ensure clean claims are submitted to the appropriate third party payer
• Communicate with Medical Billing Associates, Specialists and client when claims require additional information prior to submission
• Establish collaborative working relationship with clients as their main point of contact
• Stay abreast of current medical coding and billing issues, trends and changes in the laws and regulations in order to make recommendations for changes in policies and procedures
• Meeting monthly with Medical Billing Associates and Specialists to review aging reports in detail
• Assist Medical Billing Associates and Specialists in investigating, managing and resolving medical claims in accordance with established requirements and procedures
• Assist Medical Billing Specialists with troublesome accounts receivable balances, policy, or work flow questions
• Ensure timely and high quality service to meet and exceed client expectations and perform research on projects as needed
• Develop available resources and appropriate guidance and policies
• Organize facts, analyze and interpret information according to client circumstances
• Train team to process all payer types and various billings including no pay claims and bad debt while maintaining cost report logs
• Proficient in all main software systems used and ability to perform every function in those systems (including cash posting, ancillary posting, adjustments, claim troubleshooting)
• Act as day-to-day liaison between Medical Billing Team and In-Charge/Partner when staff require assistance
• Other duties as assigned
• Take initiative to be a team lead (proactively seek opportunities to help others)
• Treat everyone with respect
• Develop loyalty and trust within the team
• Successfully adapt to different personalities and working styles
• Proactively and effectively communicate information regarding status issues to team members
• Hold self and others accountable for assigned work; seek and provide continuous feedback to learn and develop in role; open to new ideas and suggestions
• Possesses an understanding of RKL’s business (service lines, competitors) and client service capabilities and the impact of technology upon the firm’s growth and success

Benefits

• RKL promotes a recognized culture of health and offers an extensive array of benefits to meet individual lifestyles, including but not limited to medical/dental/vision insurance, life insurance, flexible spending accounts for medical and dependent day care expenses and short-term/long-term disability.
• You’ll also receive competitive paid time off to pursue your interests or rest and recharge, and a 401(k) with employer match and profit-sharing to invest in your future.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees