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Company Name : Southeast Orthopedic Specialists
Location : Jacksonville, FL 32216
Position : Billing Manager
Job Description : Established in 2001, Southeast Orthopedic Specialists is a regional leader in orthopedic medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our wish to make industry-leading five-star orthopedic care accessible to as many people as possible.GENERAL STATEMENT OF DUTIESResponsible for organizing and maintaining financial accounting systems, including accounts payable, general ledger, employee payroll, provider compensation, cash disbursements, and financial statements for multiple entities within reporting structure. The Billing Manager will be responsible for cash application, coding compliance, charge entry, and EDI management. Support increasing business profitability by effectively managing cash posting, timely billing and charge entry, accurate coding, analyzing denials, rejections/seek best approach to overturn, and reducing days in accounts receivable.GENERAL STATEMENT OF DUTIESResponsible for organizing and maintaining financial accounting systems, including accounts payable, general ledger, employee payroll, provider compensation, cash disbursements, and financial statements for multiple entities within reporting structure. The Billing Manager will be responsible for cash application, coding compliance, charge entry, and EDI management. Support increasing business profitability by effectively managing cash posting, timely billing and charge entry, accurate coding, analyzing denials, rejections/seek best approach to overturn, and reducing days in accounts receivable.ESSENTIAL FUNCTIONSManages the day-today operations of the Cash Application Department to ensure timely payment posting, credit resolution, reconciliation of payments received and resolving unposted cash.Manages the day-today operations of the Site Billing, Coding and Billing Departments to maximize efficiencies with charge entry, claim rejections, denials, claim processing, and coding.Monitor all aspects of billing activity and initiate appropriate corrective measures as needed. Communicates performance data and associated actions plans to Senior Leadership.Identifies and implements processes to achieve key revenue cycle metrics including but not limited to Posted Charges,Suspended Claims, Rejection Percentage, Denial Percentage, Unposted Cash, Credits, and Cash Collections.Analyze large volumes of data and provide financial analysis and regularly presents trends, movements and status to Senior Leadership.Review billing work queues on a regular basis to ensure that workloads are distributed evenly and that the department metrics are being met.Resolve complex patient, physician and other issues when necessary.Manages EDI process including vendor relationships to help resolve clearing house trends.Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.Communicate with payers and know when and how to escalate payer issues.Oversee the hiring, training and supervision of department personnel.Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions.Conducts regular meetings with staff to discuss third party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.Keeps abreast of compliance regulations, standards and directives regarding governmental/regulatory agencies and/or third-party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.Must be able to meet deadlines given by Manager or Senior Leadership.Research and resolve discrepancies in a timely manner.Works with sensitive and confidential materials and must be able to exercise discretion.Responsible for accurate and timely application of transactions including adjustments and write-offs.EDUCATIONHigh school diploma/GED or equivalent working knowledge preferred.BA/BS in Business Administration, Accounting, Finance or equivalent is preferred.EXPERIENCEMinimum five years experience in a leadership role within a billing department in healthcare revenue cycle operations, coding and medical terminology.Prefer experience working with multiple physician specialties.Previous supervisory experience and strong leadership skills with an ability to motivate with a positive attitude that impacts others in a positive way.Must be AAPC Certified with a minimum of two years supervisory experience.REQUIREMENTSDemonstrated successful healthcare revenue cycle leadership experience.Experience analyzing and trending financial data.Excellent written and verbal communication and presentation skills.Excellent critical thinking, troubleshooting, and analytical skills.Excellent interpersonal skills including conflict management.Experience working in Excel (advanced formulas, pivot table)Well organized and able to meet deadlines.Excellent attention to details.AAPC CertificationKNOWLEDGEKnowledge of claims processing and editing systems.Strong knowledge of Medicare and Medicaid payer guidelines across multiple states.Knowledge of CPT, HCPCS and diagnosis coding.SKILLSSkill in effective data collection and analysis.Interpersonal skills essential to communicate effectively, written and oral, with internal and external personnel at various levels.Skill in effectively managing multiple projects simultaneously.ABILITIESAbility to multitask and work well under pressure.Ability to analyze problems and interpret information and to prioritize and reprioritize, as necessary.Ability to work independently, and as part of a team.Ability to read and interpret payer contracts.ENVIRONMENTAL WORKING CONDITIONSNormal office environment.Extended work hours at or near month end to meet department objectives may be necessary.PHYSICAL/MENTAL DEMANDSRequires sitting and standing associated with a normal office environment.Some bending and stretching required.Manual dexterity using a calculator and computer keyboard.Job Type: Full-timePay: $55,000.00 – $65,000.00 per yearBenefits:401(k)401(k) matchingDental insuranceDisability insuranceEmployee assistance programFlexible spending accountHealth insuranceLife insurancePaid time offVision insuranceSchedule:8 hour shiftMonday to FridayAbility to commute/relocate:Jacksonville, FL 32216: Reliably commute or planning to relocate before starting work (Required)Experience:Medical billing: 1 year (Preferred)Work Location: One location
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