What are the responsibilities and job description for the Billing Manager position at Amego?
The Billing Manager is responsible for managing the day-to-day operations of the medical billing department, overseeing all billing functions and ensuring efficient revenue cycle management for ABA (Applied Behavior Analysis) therapy and psychological services. This role requires strong leadership, analytical skills, and a deep understanding of healthcare billing, charge entry, revenue cycle management, and be well versed with practice management software and electronic medical records systems.
Responsibilities:
Billing and Claims Management:
o Manage the billing process for ABA therapy and psychological services, ensuring accuracy and timeliness.
o Oversee unrendered/unbilled services, prior authorizations, insurance verifications, claims submissions, clearing house, payment postings, rejections, denials, coordination of benefits, takebacks, appeals, credit balances, write-offs, and implement strategies to minimize - discrepancies.
Revenue Optimization:
o Analyze revenue cycle performance metrics and identify opportunities for improvement.
o Develop and implement strategies to optimize revenue collections and reduce accounts receivable days outstanding.
o Work closely with collection agency in transferring uncollectable accounts.
Credentialing and Contract Management:
o Manage provider credentialing and ensure compliance with state and federal regulations.
o Negotiate contracts with insurance providers and maintain relationships to optimize reimbursement rates.
o Maintain up to date contracts and fee schedules with insurance providers.
Compliance and Regulatory Oversight:
o Stay updated on healthcare regulations and ensure compliance with billing and CPT and ICD coding guidelines.
o Implement policies and procedures to mitigate compliance risks and ensure ethical billing practices.
Team Leadership and Training:
o Lead a team of billing coordinators, ensuring productivity and adherence to performance metrics.
o Provide training and development opportunities to enhance team skills and knowledge.
o Foster a supportive and collaborative work environment.
Financial Analysis and Reporting:
o Generate compliance and billing reports for submission to the finance, ensuring accuracy and adherence to regulatory standards.
o Prepare financial reports and analysis related to revenue cycle performance.
o Monitor monthly aging reports and provide information to billing coordinators to conduct follow up on unpaid claims and take appropriate action to correct and rebill for reimbursement.
o Monitor key financial metrics and provide insights to senior management for strategic decision-making.
Systems Management:
o Oversee the implementation and maintenance of billing electronic medical record (EMR), and practice management systems.
o Optimize system workflows to streamline billing processes and improve operational efficiency.
Qualifications:
· Bachelor’s degree in business administration, Healthcare Administration, or a related field.
· Minimum of 5 years of experience in revenue cycle management, preferably in behavioral health services.
· Strong understanding of healthcare billing, charge entry, CPT/ICD coding, and reimbursement methodologies.
· Experience managing billing operations across multiple states is highly desirable.
· Experience working with third party payers (Commercial, Medicare/Medicaid, etc.).
· Knowledge of regulatory requirements and compliance issues in healthcare billing.
· Excellent leadership, communication, and analytical skills.
· Proficiency in practice management medical billing software and Microsoft Office Suite.
Attributes:
· Strategic thinker with the ability to solve complex problems.
· Detail-oriented with a focus on accuracy and efficiency.
· Strong organizational skills and ability to prioritize tasks effectively.
· Ability to adapt to changing regulations and industry standards.
· Team player with a commitment to fostering a positive work environment.
