Billing Department Manager (Healthcare)

Merced Faculty Associates Medical Group, Inc.
Job Description

Job Title: Billing Department Manager
Department: Administration
Reports To: Chief Operations Officer
FLSA Status: Non-Exempt
Prepared By: Susan Harris
Prepared Date: 02/04/2025

POSITION SUMMARY:
The billing department manager oversees all aspects of a company's billing process, ensuring timely and accurate claims submission, invoicing, account reconciliation, and collection of payments, while managing a team of billing specialists to maintain efficient operations and compliance with financial regulations. They analyze and organize office operations and procedures such as medical coding and billing, new database setup and maintenance of practice management system, insurance contracting, research insurance policies and procedures, report coding updates and changes to providers, preparation of time reports, personnel information management, implement filing systems, monitor supplies, and oversees the physical aspects of the office.

BILLING OPERATIONS MANAGEMENT:
Supervise a team of billing specialists, assigning tasks and monitoring performance to ensure timely and accurate billing.Review and monitor claims periodically before submitting to insurance plans, identifying, and resolving any discrepancies.Oversee the entire billing cycle, including generating claims, applying payments, and managing customer accounts.Monitor outstanding receivables and implement strategies to collect overdue payments.Plan daily office flow, follows office budget, and initiates cost reduction programs.Maximize office productivity through proficient use of appropriate software applications.Follow established policies and procedures and directs support staff in the standards of practice.

FINANCIAL REPORTING AND ANALYSIS:
Generate reports on billing metrics such as revenue, outstanding A/R, collection rates and Company specific data on a regular basis.Submit required reports to Administration as requested.Analyze billing data to identify trends and areas for improvement, proposing solutions to optimize billing processes. Track key performance indicators (KPIs) related to billing efficiency and accuracy.

SYSTEM ADMINISTRATION:
Manage and maintain the billing system, ensuring data integrity and proper functionality.Implement updates and new features within the billing system as needed.Monitor system performance and troubleshoot any technical issues related to billing.Acts as System Administrator for related portal accounts.

COMPLIANCE AND REGULATORY:
Ensure adherence to all relevant billing regulations and industry standards.Monitor for potential billing errors and non-compliance issues, taking corrective actions.Stay updated on changes in billing laws and guidelines.Negotiate and maintain health plan contract agreements and adhere to agreement guidelines.Oversee all credentialing/licensing processes and ensure timely filing.Participant of the Quality Management team to ensure compliance with government regulations.

CUSTOMER SERVICE:
Address customer inquiries regarding billing issues and provide timely resolutions.Collaborate with other departments to resolve billing-related customer concerns.

REQUIRED SKILLS AND QUALIFICATIONS:
Proven experience in managing a billing department within a business setting.Strong understanding of billing practices, including diagnosis and procedure coding, claims generation, payment processing, and account reconciliation.Proficiency with billing software and systems.Excellent analytical skills to identify trends and patterns in billing data.Strong leadership and team management abilities.Detail-oriented with a focus on accuracy and compliance. Excellent communication and critical thinking skills to address customer billing concerns and employee needs.Must exhibit confidence in self and others and inspire respect and trust.

SUPERVISORY RESPONSIBILITIES:
Directly supervise employees in the billing department. Fulfills supervisory responsibilities in accordance with the organization's policies and applicable laws.Recruitment and training- interviewing, selecting, and training new and existing employees.Plan, assign, and direct tasks.Prepare time reports for payroll submission.Prepare appraisal performance reviews, reward, and discipline employees.Plans and coordinates team building activities within the department.Attends monthly managers meetings and reports information back to the office staff by conducting regularly scheduled staff meetings.Address complaints and resolve problems.Perform other related duties as assigned.

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:
Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one-year related experience and/or training; or equivalent combination of education and experience. Computer proficiency is required. Must be familiar with Microsoft Office programs.

LANGUAGE SKILLS:
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to draft reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from administrators, managers, clients, customers, and the public.

MATHEMATICAL SKILLS:
Ability to calculate figures and amounts such as discounts, proportions, percentages.

REASONING ABILITY:
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to diffuse adverse situations before they escalate. Ability to identify problems and develop alternative solutions in a timely manner. The ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee frequently is required to walk and sit. The employee is occasionally required to stand; reach with hands and arms; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to twenty-five pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

I have read this job description and understand the responsibilities and requirements of this position.

____________________________ ______________________________
Employee Name Employee Signature & Date

____________________________ ______________________________
Supervisor Name Supervisor Signature & Date

Note: MFA retains the right to change or modify job duties at any time. The above job description is not all encompassing. Needs and requirements may vary according to business demands or necessities.