Medical Billing Manager

WebMed Mental Health Services
Cloquet, MN Full Time
POSTED ON 8/20/2023 CLOSED ON 12/16/2023

What are the responsibilities and job description for the Medical Billing Manager position at WebMed Mental Health Services?

WebMed Mental Health is seeking a detail-oriented, highly organized Medical Billing Manager to provide leadership to the billing department to ensure optimal cash flow, as well as improved relations with providers, clients, and insurance companies. This position is responsible for managing the revenue cycle and acts as the expert and go-to person in the department for all processes relating to coding and billing.

WebMed provides outpatient psychiatric and substance use disorder services to a diverse client population in Duluth and Cloquet. Come join our team! We offer a comprehensive benefit package and a Monday through Friday clinic schedule.

Essential duties and responsibilities include but not limited to:

General:

  • Perform as a practice expert in the department on all issues relating to billing processes
  • Supervise the billing department operations; perform duties such as charge entry, payment posting, reimbursement management, referral intake and insurance verification, claim submissions, and accounts receivable follow-up
  • Carry out audits of current procedures and processes, discover billing operations areas to improve on and affect the necessary actions
  • Carry out analysis of trends affecting coding, charges, accounts receivable, and collection, and assign manageable tasks to billing staff
  • Collaborate with other departments to obtain and analyze additional information about patient financials to be able to record and process billing effectively
  • Ensure the billing department carries out all its activities in accordance with its overall protocol, and also that they comply with payer, State, and Federal requirements, regulations, and guidelines
  • Remain updated on HIPAA and all other health information management issues and regulations
  • Give report of all concerns and issues at the department to the Clinic Manager for prompt necessary action.
  • Ensure effective communication with team members and leadership
  • Support team members, covering areas for lunches, breaks, and vacations
  • Maintain and practice patient confidentiality. Demonstrate overall professionalism in attitude, demeanor and personal appearance
  • Adhere to all WebMed company policies and procedures as outlined in the employee handbook

Supervisory Duties:

  • Train, allocate work, and resolve problems among billing office personnel
  • Carry out performance evaluation of personnel and recommend necessary actions
  • Provide motivation to employees to achieve their best performance and high degree of productivity
  • Ensure quality and appropriate trainings are provided to newly hired and existing billing staff through effect supervision and coordination of the training process, and by adhering to established company operating policies, procedures and systems, protocols, techniques, and standards

Billing Tasks:

  • Ensure unpaid claims are reviewed and appropriate action is taken.
  • Work denials and appeal as appropriate.
  • Write appropriate appeals, send to the payer and follow up on in a timely manner.
  • Apply appropriate insurance adjustments as needed.

Authorizations:

  • Contact insurance companies and provide information requested for preauthorization and reauthorization as needed.
  • Monitor clients’ prior authorization status
  • Manage prescription and service prior authorizations, inform client of approvals and denials
  • Insurance/Consolidated Funds: manage all aspects of insurance processed from treatment authorizations through discharge

Credentialing:

  • Assist with credentialing of new providers
  • Monitor and update credentialing status of current providers
  • Assist with contracting with new insurance companies

Other:

  • Assist with records requests from outside agencies
  • Complete MNSure navigator training and be available to provide MNSure navigation service
  • Maintain up to date knowledge of coding: CPT, HCPCs and ICD-10
  • Other duties as assigned by Clinic Manager

Required Skills/Abilities:

  • Must have verbal communication skills and hearing ability to discuss billing with staff and clients
  • Possess profound knowledge and understanding of rules and regulations affecting medical billing and insurance verification
  • Deep knowledge and understanding of revenue cycle, collections and payment posting, medical billing, Medicare and Medicaid, and third party payers
  • Thorough knowledge and working experience of CPT, HCPCs, and ICD-10 codes, HIPAA, medical terminology, appeal processes, billing and insurance regulations, and insurance benefits
  • Solid knowledge of basic accounting principles and business management to be able to effectively give direction to the billing office
  • Profound knowledge of company policies and procedures to be able to provide the right answers to inquiries from all customers (both internal and external)
  • Strong negotiation skills to be able to effectively deal with customers and secure payment, as well as to be able to discuss the finances of patients
  • Possess current knowledge of technologies in the health information sector and their applications
  • Strong interpersonal skills to be able to effectively relate with the public, patients, organizations, and other employees
  • Strong skills in carrying out every part of the work process, i.e. development, implementation, and administration, effectively
  • Detail-oriented with the ability to work under pressure and frequent interruptions from staff and patients without being distracted
  • Strong ability to communicate effectively with staff, colleagues, patients, physicians, and insurers in person, over the telephone, and in writing
  • Strong ability to display exceptional initiative and work under little or no supervision
  • Strong ability to train and supervise the work of employees; effectively organize, prioritize, and schedule tasks to ensure practice timelines are met
  • Strong ability to handle problems consisting of multiple variables in an organized manner.

Education and Experience:

  • High school graduate or equivalent; bachelor’s degree preferred
  • Experience working in a supervisory or management position
  • Strong experience of medical insurance/healthcare billing and collections work in a health system or medical practice

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer.

WebMed prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

EOE

Job Type: Full-time

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • Day shift
  • Monday to Friday

Work Location: Hybrid remote in Cloquet, MN 55720

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