Position Summary
The Billing Manager oversees the Billing Department.
This position supervises all claims (HCFA, UB92's) on a weekly basis, reviews claims for completeness or errors, and fixes all minor errors, such as missing CPT codes and ICD-9. Requires extensive knowledge in medical billing, HMO encounter data, and CHDP reporting. May perform other clerical and billing duties as assigned by the Controller or Executive Director.
Schedule:
- Flexible, may require some evening and weekends
- Hours worked per week may exceed 40 hours
Primary Duties and Responsibilities
- Supervise and oversee the Medical Billing Supervisor, Medical Billing Lead, Medical Billers, and the Medical HCC Coder.
- Review all claims for completeness and errors and correct them accordingly.
- Monitor the submission of encounter data (HCFA 1500) to the appropriate health plans.
- Review all denials for complexity, make corrections, and resubmit claims within 30 days of the denial received date.
- Monitor the billing of the BCDP, CHDP, Medi-Cal, CPSP, PPP, EAPC, HMO, Medicare, and other funding sources.
- Responsible for running all billing reports, researching reports for re-bills, and maintaining report books by funding source.
- Assist with pulling all required medical billing documents needed for site sites for all clinics and administrative audits.
- Review weekly "billed" report with department manager.
- Inform clinic managers of "unbilled" or "go-backs" claims on a daily/weekly basis.
- Generate weekly revenue report status to management team.
- Other duties assigned by the Controller or Finance Director.