Billing/Coding Manager

Summary: Responsible for managing the billing/coding function across the organization. Oversees and performs billing/coding duties alongside the billing/coding staff by performing the following duties.

Duties and Responsibilities include the following. Other duties may be assigned.

• Manages the day-to-day functions of Genesis PrimeCare billing and works closely with the Director of Revenue Cycle.*
• Makes written and oral reports/recommendations to Director of Revenue Cycle concerning billing/coding functions.*
• Assists in standardizing methods in which work will be accomplished.*
• Identifies patient accounts that meet collection requirements.
• Reviews patient credit balances and prepares patient refund requests.
• Submits refund requests with appropriate backup to the Director of Revenue Cycle.*
• Reviews claims, claim denials, and payments for accuracy and reports to the Director of Revenue Cycle.*
• Identifies claim errors and researches for cause of errors.*
• Communicates with insurance companies when necessary to resolve claim issues.*
• Communicates identified internal errors to appropriate parties in effort to educate and eliminate future errors.*
• Assists and prepares and submits clean claims to various insurance companies either electronically or by paper when needed.
• Answers questions from patients, clinic staff, billing staff, and insurance companies.*
• Identifies and resolves billing/coding complaints and reports to the Director of Revenue Cycle.*
• Reviews and approves all adjustments/write-offs that are not usual contractual adjustments.*
• Trains staff when Coordinator is not available and trains the Coordinator when needed.
• Participates in educational activities.*
• Conducts self in accordance with Genesis PrimeCare's employee manual.*
• Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations.*
• Performs other related duties as assigned.

Supervisory Responsibilities:

Directly supervises all employees in the Billing Department/Coding department located at the Administration Office and other locations. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Education/Experience:

High school diploma or general education degree (GED), AS/AA degree preferred; minimum 5 years billing/coding related experience and/or training and two to four years management experience; or equivalent combination of education and experience.

Specialized Training:

• Extensive knowledge of medical billing/collection practices
• Knowledge of basic medical coding and third-party operating procedures and practices

Certificates and Licenses:

• Billing certification preferred
• Coding certification preferred

Knowledge, Skills and Other Competencies:

• Interpersonal skills
• Management skills
• Typing skills
• Oral communication skills
• Written communication skills
• Employee Development
• Strategic Thought

• Reading and comprehension skills
• Customer service skills
• Ability to be organized and detail oriented
• Professionalism
• Time management skills
• Leadership
• Results Driven