Billing Manager

Position Summary (On-Site)

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.