Billing Manager

• Experience managing billing services for U.S based practices preferably in ABA field


• Experience on leading EMR platforms OfficeAlly etc


• Strong domain exposure to Charge Entry, Payment Posting, Claims mgmt./adjudication, Coding, Enrollment, Billing, Audits, Denials & AR Management


• Ensure billing and coding for all current and new medical service lines are accurate, consistent, and maximize revenue opportunities. Evaluate, report on, and improve results after implementation of new services or payers.


• Report and resolve payment and system issues with urgency, escalating if needed and putting processes into place to prevent similar future issues.


• Ensure everyday the billing staff and team have scrubbed all the superbills and have sent them to the clearinghouse.


• Plan, implement, evaluate, and administer all Revenue Cycle strategies and processes, including authorization, eligibility and benefits verification, claims submission, payment posting for ERA’s, denial management, accounts receivable follow-up, reporting and aged claims.


• Analyze current and potential contracts in terms of costing, volume, and reimbursement rates and use findings to drive contract strategies.


• Sent Patient statements and collections monthly- apply all patient credits prior to sending out statements.


• Must collaborate with the collection agency, provide authorization for collections agencies to initiate small claims actions etc.


• Respond and research patient inquiries received relating to billing.


• Daily batch total balanced.


• Ensure ongoing knowledge and compliance with all contracts beyond initial implementation and throughout the full revenue cycle.


• Monitor, respond to, and communicate changes in billing requirements, regulations, and reimbursement rates, and maintain provider enrollments with payers.


• General ABA knowledge.


• Monitor accounts with payment plans.


• Update & enter in OP (EMR) all information that has to do with billing, such as new codes, prices changes/increases, etc.


• Increase revenue though the proper billing channels.


• Works with management assure billing is being completed properly.


• Participate in projects or other duties as assigned.


• Processing Payments/ensure billing staff/team is completing all payments in a timely manner.
  


• Willing to work effectively with other departments.


• Familiar with Windows/Word/PowerPoint Etc.


• Excellent Excel Knowledge is required.


• Credentialing Experience Preferred, CAQH updates


• Must be aware of Out of Network Limitations.


• Comfortable presenting account status to senior management .

Additional Responsibilities

• Responsibility for managing the billing department and staff


• Responsible for ensuring optimal service levels are maintained..

• Completely monthly or quarterly staff reviews (No financial decisions will be made by the manager; just improvements and praises on a billing stand point).


• Monitor insurance incentive programs (NCQA, PHO and CSMS)


• Provide weekly claims & payment collection reports.


• Provide monthly MIS reports


• Resolve billing software issues with insurance companies and clearinghouses.

• 10 Years as a billing manager (Medical Billing and or coding experience)


• Should have experience setting up a billing company.


• Should have experience setting up processes for successful billing operations.


• Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent attention to detail.


• Very strong interpersonal and customer service skills.


• Must possess superior organizational skills.


• Expert level written and verbal communication skills.


• Detail oriented, meticulous.


• Demonstrated proactive approaches to problem-solving with strong decision-making capability.

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• Highly resourceful team-player, with the ability to also be extremely effective independently.


• Proven ability to handle confidential information with discretion.


• Demonstrated ability to achieve high performance goals and meet deadlines in a fast paced environment.


• Forward looking thinker, who actively seeks opportunities and proposes solutions.


• Ability to multitask.


• Use of computers and software programs (EXCEL, WORD, POWERPOINT, EMR)


• Prior experience with the Central Reach system is desired but not mandatory.

Salary – INR 85,000 – 100,000/- per month