Sr. Medical Billing Manager

Community Connections, Inc.•Washington, DC

3d•$80,000 - $95,000•Hybrid

About The Position

The Senior Medical Billing Manager is responsible for oversight and execution of the billing process, including billing claims, coding, and reimbursement. This involves monitoring billing information to ensure accuracy and resolving any discrepancies. This person must be knowledgeable in medical coding and reimbursement regulations, especially for Medicaid, and be able to communicate effectively with insurance companies and other payors. The Senior Medical Billing Manager is also responsible for training and supervising staff and providing on-going support.

Requirements

Bachelor's degree in finance or accounting relevant field or equivalent experience
5-7 years of medical billing experience required
Strong knowledge of basic accounting principles
Possesses intermediate computer skills with demonstrated strengths in Excel and EHR software
Minimum of 5 years experience in progressive management position with proven track record of managing a team to achieve results
Comprehensive knowledge of claims management, HIPAA standards, CMS requirements, managed care, CPT, ICD-9 and 10, and HCPCS coding
Ability to successfully communicate and interact with all levels of individuals within the organization
Collaborative skills to form strong working relationships with vendors, other departments, and senior management

Nice To Haves

SmartCare by Streamline experience a plus

Responsibilities

Performs overall revenue management including satisfying timely filing requirements, maximizing billing revenue and collections, and resolution of denied/rejected claims
Responsible for the oversight of timely posting, tracking, and reporting on claim transactions, and completing corrections for denied claims to ensure collections in a timely manner. Provides coverage when billing manager is out of office and assists with process to ensure it is completed on a contemporaneous basis
Perform account reconciliations on a monthly and yearly basis for fee-for-service revenue and accounts receivable general ledger accounts
Responsible for review and reporting, as well as developing and executing, a collection strategy for outstanding receivables and unbillable claims, to maximize revenue and collectability
Create reporting, as necessary, to facilitate analysis of fee-for-service program performance
Create reporting, as necessary, to facilitate analysis of managed care program performance, including the integration of necessary clinical information with billing information in pay-for-value reimbursement model.
Assist with implementation of Current Expected Credit Loss (CECL) calculations for financial reporting and provide on-going support in updating the calculation on a quarterly basis
Supervise revenue cycle and billing staff
Write formal staff evaluations, provide feedback to the staff and offer mentoring opportunities to allow staff to grow and achieve agency outcomes
Develops, implements, and maintains revenue cycle standard operating procedures
Researches and maintains compliance with all governmental billing regulations
Develops relationships with all payers
Attend provider meetings with respective payers such as Department of Behavioral Health (District of Columbia) or commercial insurers, as well as internal meetings with program heads and senior leadership on occasion.
Lead and work effectively in a team environment
Models and reinforces Community Connections mission to provide behavioral health, residential services, and primary health care coordination for marginalized and disenfranchised women, men, youth, and children living in the District of Columbia, many of whom are coping with challenges including mental illness, addiction, and the aftermath of trauma and abuse.
Models and reinforces Community Connections values of quality, innovation, respect, equity, and integrity daily.
Reinforces Community Connection’s commitment to diversity, equity, and inclusion.
Protects the privacy of our consumer’s protected health information by maintaining compliance with HIPAA and other relevant CC related IT security regulations.
Completes and stays current on role specific and organizational wide training.
Performs other duties as assigned on an as-needed basis.

Benefits

Generous paid time off, including sick, vacation, and 9 paid holidays
Medical, Dental, and Vision Insurance
Medical and Dependent Flexible Spending Accounts
Agency paid Long-term disability and life insurance
Employee paid Voluntary life insurance
Employee Assistance Program
403(b) Retirement plan
Educational assistance after one year of employment
CEU & Licensure reimbursement
Professional and leadership development to include supervision hours for those on track for clinical licensure