Home Health Billing Manager

Job description

Job Description Summary for Home Health Billing Director & Director of Revenue Cycle

Reports to: Executive Director / Administrator

Essential Job Functions / Responsibilities

Oversee, establish, maintain and responsible for:

• Reimbursement through efficient billing and collections operations and effective accounts receivable management.
• Oversight and approval of claims audits and processing. Conducts final billing audit and issues assignments to pre-billing team when findings require further documentation.
• Monitoring and reporting Medicare and Medicaid regulatory updates
• Comprehensive working knowledge of payer contracts and ensures that payers are billed according to contract provisions. Represents and acts on behalf of the agency in resolving conflicts with payers.
• Comprehensive working knowledge of government billing regulations including Medicare and Medicaid regulations and serves as a resource for appropriate agency personnel.
• Aged accounts receivables and resubmit bills to overdue accounts, submits seriously overdue accounts to collection agencies for collection, and prepares bad debt reports for weekly meetings.
• Gathers, collates, and reports key billing information to billing team.
• Works with Executive Leadership Team in strategizing monthly, quarterly and annual goals for optimized billing efficiency.
• Successfully reconciling the billing system reports with the general ledger.
• Reconciles Medicare quarterly reports produced by the fiscal intermediary with the billing information system.
• Use of the billing information system and maintains a comprehensive working knowledge of the system including upgrades and enhancements.
• Cash receipts and bank deposits according to policy.
• Positive working relationships with patients, family members, payers and referral sources.
• Billing and patient accounts record systems are maintained in accordance with generally accepted accounting principles and in compliance with state, federal and Joint Commission regulations.
• Protects the confidentiality of patient and agency information through effective controls and direct supervision of billing operations.
• Day-to-day operations of the department, assigning work list files to billing staff
• Training on all systems for new staff.
• Supervising contact with guarantors and third party carriers regarding account resolution
• Special projects with regard to billing and payment issues.
• Evaluating account follow-up activity and conducting quality reviews.
• Patient account review and provide feedback to financial counselors in order to improve performance and Q.A.
• Identify denial trends, root cause, and action steps to correct.
• Lead internal and external financial and regulatory/compliance audits, including subsequent monitoring

Third Party Claims Processing: Oversee, establish, maintain and responsible for

• Verification of all of the information for claims billing is correct in EMR . Contacting the appropriate person to obtain missing or unclear billing information. Documents all tasks in EMR. Including notes/history.
• Reviewing all funding invoices to determine the correct billing method. Completes claim form through EMR database, or internet web site (if required) ensuring that all fields required by the third party in question are complete and accurate. Attaches required documentation for payment.
• Denied & unpaid claims through activities. Determines next course of action, which may require rebilling missing claims, denied claims OR sending additional information on pending claims.
• Completing all necessary follow-up in a timely manner so the payment process will not be delayed. Must stay current on follow ups, so billing deadlines are not missed.
• Interaction with customers concerning all aspects of billing through phone, email or regular mail in a prompt and courteous manner.
• Relaying changes in Medicaid, MCO, Medicare, HMO regulations discovered by claim denials to all pertinent personnel including other billing employees or management.
• Identifying issues at the claims portion of that would affect the prior authorization portion or other interconnected areas.
• Bringing changes needed on a Prior Authorization before a claim can be processed to the attention of management. that originally processed the Prior Authorization form.
• Accounting to collection agency, all cash posting and all cash undistributed functions
• Relaying updated information regarding state policy changes to the department.
• Other duties/projects assigned by the Management.

Job Type: Full-time

Pay: $190,000.00 - $200,000.00 per year

• Benefits:
• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday, 9:00am-5:30pm

Education:

• Bachelor's (Required)

Experience:

• home health billing: 2 years (Required)

Work Location: In person