A pillar of the medical community for more than 30 years, we are the preeminent Ear, Nose and Throat practice serving the Tampa Bay area. Board-certified and expertly trained, our esteemed ENT Physicians, Doctors of Audiology and Allergy Staff are dedicated to helping adult and pediatric patients make sense of their hearing, sinus, allergy, sleep, throat and facial cosmetic problems.
Our mission as a patient-centered practice is to provide expert, timely and compassionate care in a safe, friendly environment, and restore your health using the most advanced diagnostics and treatments. We want all of our patients to be informed decision makers and fully understand their ENT-related health issues.
We are looking for an experienced Billing Manager to manage our Billing and Credentialing depts. This position is eligible for a hybrid remote work schedule upon successful training completion.
Position Summary: The Billing Manager is responsible for overseeing the billing and coding staff and making day-to-day decisions. Individual will direct and coordinate the overall functions of the billing office to ensure maximization of cash flow while improving patient, physician and other customer relations. The Billing Manager will be required to produce, analyze and present detailed billing activity reports. The Billing Manager is also responsible for overseeing the credentialing process for the practice.
Reports to: The Billing Manager reports directly to the Practice Administrator.
Flexibility: While this job description is meant to provide an overview and specific responsibilities of the Billing Manager, ENTA Management reserves the right to make changes, adjustments, and revisions, as needed, to this document and will coordinate such modifications with ENTA’s Practice Administrator and Physicians.
Summary of General Duties:
- Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
- Serves as the practice expert and go to person for all coding and billing processes
- Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection
- Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
- Follow up on claims using various systems, i.e. practice management and Encoda
- Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
- Prepares and analyzes accounts receivable reports, and weekly and monthly financial reports in concert with the Practice Administrator. Collects and compiles accurate statistical reports
- Audits current procedures to monitor and improve efficiency of billing and collections operations
- Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements
- Participates in the development and implementation of operating policies and procedures
- Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency
- Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Practice Administrator.
- Keep up to date with carrier rule changes and distribute the information within the practice
- Performs physician credentialing actions
- Understands and remains updated with current coding and billing regulations and compliance requirements
- Maintains library of information/tools related to documentation guidelines and coding
- Manages billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
- Provides, oversees, and/or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques
- Coordinates team member time off in a manner that does not negatively impact necessary daily functions.
- Other duties as assigned by the Practice Administrator
GENERAL RESPONSIBILITIES:
- Performs all duties and responsibilities in an efficient, team-oriented manner.
- Accountable for being knowledgeable and understanding of all aspects of the billing and coding staff duties to include:
- Entering patient demographics and insurance information
- Verifying patient eligibility and benefits for upfront collection on unmet deductibles and co-insurance o Responsible for reviewing operative reports within three business days of procedure/surgery
- Enter charges accurately according to insurance payers/contracts o Submitting clean claims by attaching necessary documentation for payment
- Follow-up on electronic claims and paper claims
- Posting insurance payments to patient accounts .
- Submit all secondary claims when necessary
- Refund money owed to patient or insurances
- Conducts self in a manner that reflects a positive representation of the practice and encourages others to do the same.
- Observes strict patient confidentiality in dealing with patients
Working Environment:
- Physical demands:
- Average percent of time during regular shift devote to:
- Walking, Squatting, Sitting, Bending, Reaching: 75%
- Standing: 25%
- Average lifting requirements:
- Lifting Requirements: 20-40 lbs.
- Frequency of Lifting: 0-25% of the time
- Additional physical demands:
- Ability to grasp with both hands; pinch with thumb or forefinger; turn with hand/arm; reach for (above shoulder height).
- Ability to type 60 wpm.
- Ability to operate multi-line telephone system, computer keyboard and ten-key adding machine.
- Visual, Hearing, and Mental demands: Vision adequate to perform essential functions such as read telephone displays/computer terminals for long periods of time, correctable to 20/20. Hearing is adequate to perform essential functions such as answering the telephone. Mental capacity adequate to perform essential functions such as quickly and accurately entering patient demographics and scanning documents while checking in multiple patients. Tact to deal with unfriendly individuals regarding various situations, and adequately handle stress.
- Working Conditions: Required to exhibit a positive attitude and a professional appearance and show detail and accuracy. Required to exhibit quality performance of the essential job functions to help the practice run effectively and efficiently.
Position Requirements:
- Associate’s degree, preferably in business administration or related field; Bachelor's degree preferred. 7+ years of medical insurance/healthcare revenue cycle experience will be considered in lieu of the degree.
- Medical coding certification
- Minimum of 3 years medical insurance/healthcare billing and collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations. Otolaryngology preferred.
- Two years supervisory or management experience required
- Ability to communicate effectively with patients, physicians, and staff in a courteous manner.
- Ability to analyze cost/reimbursement of accounts.
- Medical Terminology including CPT-4 procedure coding. ICD-9 diagnostic coding, and HCPCS coding preferred.
- The ability to attend work on a regular basis
- The ability to adhere to safety rules and other reasonable regulations pertaining to the job
- The ability to refrain from negativity or excessive irritability
- The ability to work in cooperation with other workers