Job Functions, Duties, Responsibilities and Position Qualifications:

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The Billing Manager will supervise, maintain and enhance the overall billing department system with regards to the laboratory’s mission statement and goals and to provide departmental leadership for billing staff. They are accountable for accomplishing all aspects of the daily operations of the Billing Department through direct participation, coordination and supervision of the Billing team.

Essential Key Responsibilities:

Coordinate and maintain all functions, duties and responsibilities associated with the overall billing system. This includes, but is not limited to, coding charge entry, claims release, payment posting, patient statements, client billing, A/R, and collections. Assumes personal responsibility that all department functions are completed accurately and in a timely manner.
Continually improve and make more efficient the billing operations, from input (request form) to output (deposits and reports). This includes, but is not limited to, setting up electronic payors, setting up Electronic Fund Transfers, participation in Pilot or Beta testing applicable, identifying BIS programming enhancements, and maintaining document control.
Perform month end closing and reconciliations and generate reports for Corporate Finance within the required schedules provided. Analyzes data for statistical trends.
Ensure all SOX compliance documentation is maintained and participate in SOX audits.
Maintain billing materials as required by Retention Policy.
Ensure Billing Quality Assurance is completed aiding our participation in the Company’s Compliance Program. Monitor quality assurance through the use of problem log documentation and tracking. Keep the Regional Billing Manager and General Manager informed by producing regular statistical reports on productivity. Possess the capability of identifying problems that may adversely affect the billing process. Be competent to either correct the problem or immediately notify the Regional Billing Manager or General Manager of the problem.
Comply with all State, Federal, professional regulations as well as company and departmental rules, polices, and procedural manuals. Communicate with the Regional Billing Manager and General Manager on potential legal issues, such as Stark, Anti-kickback, HIPAA, etc. Adhere to CAP, CLIA, State Regulations, HIPAA, Safety and OSHA Regulations.
Train and educate billing staff on changes in healthcare industry and billing processes using a team-oriented approach. Perform/Instruct on billing matters consistent with applicable Federal and State regulations. Hold regularly scheduled Billing meetings to ensure all staff are up to date on billing matters. Possess the ability to effectively interact and communicate with all staff in order to maintain a sense of teamwork within the Company.
Supervise staff and day –to-day operations of billing department utilizing established departmental benchmarks and operational goals. Develop and implement policies and procedures for billing and reimbursement functions to ensure prompt error free work flow.
Complete Performance reviews for the Billing Department. Process and approve time off requests for members of the billing department.
Acts as a liaison between the Regional Billing Manager, General Manager and Billing Department to promote efficient gap free accomplishment of office operations. Coordinate regular meetings for leaders and staff to review operations and resolve issues.
Process requests for indigency discounts.
Assist in the preparation of refunds and/or offsets.
Handle all incoming patient and insurance bankruptcies.
Complete all “Verification of Medical Expenses” forms for HUD housing applicants.
Ensure prospective insurance contracts are identified and handled appropriately.
Responsible for maintaining strong and positive relationships with clients and patients in regards to billing questions, problem resolution, etc.
Functions as a liaison between specimen acquisition and the billing department for proper insurance knowledge.
Participate in Continuing Education. This can be done in the form of watching a video/DVD, attending a seminar or participating in another form of in-house training. Documentation of participation is given to the General Manager.
Maintains strictest confidentiality.
Perform other various duties as requested by the Regional Billing Manager or General Manager.

Education/Licensure/Certification:

Associate Degree and/or 5+ years related work experience in a healthcare organization
Certified Professional Coder (CPC)

Experience:

5+ years experience in a healthcare billing environment.
5+ years prior leadership/supervisory experience

Equipment:

Computers, computer programs, information system(s), photocopiers, scanners, facsimile machines, voice mail systems and telephones.

Knowledge/Skills/Abilities:

Knowledge of clerical procedures.
Knowledge of health insurance billing and processes, provider plans and payor contracts.
Knowledge of insurance carrier payment policies, practices and amounts.
Knowledge of CPT and ICD codes and lab requisitions.
Knowledge of English grammar, spelling, and punctuation.
Skill in using computer programs and applications.
Skill in typing a minimum of 40 WPM.
Skill in using a 10-key calculator.
Ability to listen, read, understand, and follow oral, and written instruction.
Ability to sort and file materials correctly by alphabetic or numeric systems.
Ability to communicate clearly and concisely.
Knowledge of governing regulations and standards related to healthcare billing, collections, and client satisfaction
Excellent in areas of critical thinking, analytical skills and interpersonal relationships.
Excellent problem solving and continuous improvement skills.
Ability to establish and maintain positive relationships with employees, physicians, vendors, clients, and external agencies.

Scheduled Weekly Hours:

Work Shift:

Job Category:

Accounts Receivable

Company:

Sonic Healthcare USA, Inc

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.