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Billing Office Manager, Issaquah, WA


Proliance Surgeons-Bellevue Ear Nose and Throat

Manager

Issaquah, WA

May 22, 2019


Responsible for the management of patient billing processes. Develop work flows and processes and improve operational goals of department. Supervises all billing and surgery scheduling employees, including related recruitment and hiring, performance management, progressive discipline, training and development. Provides billing oversight and expertise to the billing office and clinic staff. This includes the full cycle of patient account representation- from clinic visit coding to the data entry of payments and adjustments and the handling of billing inquiries and collections. Provides oversight of surgery scheduling work flows. Additionally, this role is superuser for the practice management and electronic medical records systems, including participating in attestation and data testing for quality measures.

The essential qualities necessary include, but are not limited to:

  • Respectful, patient and pleasant personality; works well with diverse people
  • Flexible attitude; adaptable to new challenges and projects
  • Team player
  • Ability to work independently, with little supervision
  • Excellent public relations
  • Interfaces well with staff and physicians
  • Professional demeanor

Experience

Minimum five years medical business office accounting experience; two years as a department manager in patient accounts. Background in surgical practice preferred. Requires previous supervisory background.

Knowledge

  • Knowledge of business management and basic accounting principles to oversee the billing office.
  • Skilled in supervision and leadership of teams.
  • Understanding of computer accounting programs, spreadsheets and applications.
  • Skilled in medical terminology, coding and medical office procedures. Certified coding qualifications preferred.
  • Background with third party and insurance company operating procedures, regulations and billing requirements and government reimbursement programs.
  • BS/BA preferred
  • ENT experience preferred

Duties and Responsibilities

The Business Office Manager is expected to perform position-related duties that include, but are not limited to:

  • Directs and coordinates the overall functions of the Billing Office to ensure maximization of accounts receivables while improving patient, physician and customer relations.
  • Plans and leads patient billing, insurance, collections, referrals and authorizations and data processing to ensure accurate patient billing and efficient account collection.
  • Reviews ongoing status of patient accounts to identify and resolve billing and process problems in a timely manner.
  • Recommends and establishes credit and collection policies. Develops ongoing solutions for improvements.
  • Solves difficult payment and associated business office problems. Audits problem accounts.
  • Develops and implements new procedures to improve the quality and quantity of work processed. Ensures policies are communicated and administered consistently.
  • Leads physicians and providers by training and mentoring in clinic coding and billing practices.
  • Supervises, trains, orients and evaluates performance of billing and surgery scheduling staff. Recommends merit increases, promotions, disciplinary actions.
  • Schedules coverage – ensures adequate staffing levels. Approves payroll for direct reports.
  • Monitors daily operating activity of department and makes necessary adjustments in work assignments.
  • Prepares, writes and analyzes reports.
  • Oversees month-end and year-end closure processes.
  • Responsible for all the following billing department activities:
    • Entry of charges and payments posting for all services, attorney depositions, conferences, and narratives.
    • Reconciliation and audit of correct payments on accounts
    • Daily bank deposits/returned checks
    • Contacts health plans in regard to contract issues
    • Timely accounts receivable collections
    • Writing appeal/protest letters to insurance companies as necessary
    • Posting of private and insurance payments
    • Refund processing
    • Updating patient insurance information, including memo entry for billing documentation
    • Customer service - answering billing inquiries from patients and/or healthcare providers/insurance companies
    • Posting of co-pays/pre-pays data
  • Responsible for all the following surgery scheduling department activities:
    • Procedures and processes for efficient scheduling of surgical cases
    • Communication and development of processes with facilities
    • Escalation of authorization or peer review issues involving contracting with health plans
    • Managing variations in staff work flow for optimal patient service
  • Handles escalated calls. Responds to patient complaints and compliments related to areas of responsibility.
  • Approves refunds for patient or insurance over-payments
  • Practice Management System Superuser – adds CPT codes; maintains doctor and insurance masters in conjunction with Proliance central office. Develops strategies to meet quality metrics and testing.
  • Electronic Medical Record Superuser – leads strategies to optimize use of records for compliance and testing.
  • Participates in preparation of data and reports for quality measures.
  • Provides support to other clinic processes as directed by Practice Administrator.
  • Jointly directs Issaquah clinic facility maintenance and vendors with Practice Administrator.

Send resume to g.smith@proliancesurgeons.com


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