The Medical Billing Manager’s primary focus is to manage the medical billing functions for the residential facilities/programs. The primary objective of this position is to develop and manage the billing process to ensure accuracy of work, mitigate denials, oversee authorizations and continually work on system/workflow improvements. This position is specifically focused on voluntary admit services provided.

The billing team’s focus is to manage medical invoicing and related documents to ensure proper documentation is remitted to solidify payment. The main focus of this work centers around timeliness and accuracy of documentation.

The Medical Billing Manager is expected to make continuous improvements to workflows, trouble shoot problems and work with other members of the management team to propose solutions. Creating and monitoring productivity benchmarks to manage cash flows and the team’s performance is an expectation of this position.

This is a management position including supervision of staff and outsourced billing team. This position will develop and organize the medical billing processes and procedures in conjunction with other member of the revenue cycle team. It is expected this position will manage communications with direct reports, provide continued training, coaching, counseling, and performance reviews.

Essential Job Functions:

· Ensure the billing team’s work functions in line with the mission and goals of the Company.

· Responsible for oversight of the billing cycle to ensure compliance with government contracts and Washington State Administrative Codes

· Responsible to manage medical denials and direct billing team’s work to solidify payment or approve write offs. Ability to teach denial management through example and set the precedence for best practices.

· Responsible to ensure single case agreements are negotiated to acceptable rates and process is followed through to completion to solidify payment or bill secondary insurance

· Responsible to manage the Utilization Team for these services to ensure authorizations are completed correctly, help provide education regarding authorizations/billing for accuracy to prevent billing denials.

· Responsible to understand clinical language and work with Facility Administrators/Clinical Directors to ensure directive to teams is in line with operations.

· Supervise the collection of statistical data and other information to support decisions and identify issues to be resolved.

· Responsible to review work of subordinates for accuracy, ensure timeliness of completion & reduce denials to ensure payments are received in full within the payer contract timeframes.

· Responsible to understand and review clinical billing codes in relation to payor contracts, billing guides and other relevant sources (Service Encounter Reporting Instructions – SIRI guide).

· Responsible to work with other teams, including but not limited to: Involuntary Utilization Team, Electronic Health Records Team (EHR), Admissions, Finance & Clinical

· Respond to the directives of the supervisor and management staff in a professional and cooperative manner.

· Assure that all patient needs are met with dignity and respect

· Understands and facilitates federal confidentiality laws, 42 CFR, and protects client confidentiality/anonymity, and assures no information is shared without proper authorization.

· Compliance and understanding of HIPAA laws

· Other duties as assigned

Competencies, Skills and Attributes:

• Must have strong people management skills and ability to hold people accountable
• Ability to work & learn independently
• Ability to work with other managers to guide teams in the direction of company goals/initiatives
• Must be collaborative and maintain a team player mentality
• Ability to meet deadlines and manage workflows
• Proficiency with Excel, and Microsoft Office/SharePoint
• Ability to communicate clearly and effectively, complete work accurately, and meet deadlines
• Ability to inspire team members to accept and embrace positive changes

Minimum Requirements:

· 5 years of experience managing direct reports

· 5 years of experience working in medical billing management role

· Preferred not required, Certified Professional Biller & completion of billing program

· Preferred: medical coding experience

· Ability to pass all ABHS prescreening requirements, including but not limited to criminal background check & drug testing

Job Type: Full-time

Pay: $90,000.00 - $100,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Hybrid remote in Spokane Valley, WA 99037