Billing Systems Manager jobs in Cincinnati, OH

Responsible to: Chief Operating Officer 

Position Description- Manage billing processes, manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. Assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting. 

• Support the mission, vision and values of the organization and CEO. 
• Complete deadlines in a timely manner with accuracy. 
• Set up providers, such as Medicare, HMOs, and private insurance.  
• Update billing codes, and related information as needed. 
• Process monthly billing to payor sources. 

• Reconcile failed activities in EMR (Carelogic) and claims as needed. 
• Upload billing records to clearinghouse (Alevo, Gosh, etc) 

• Follow-up on unpaid claims, denials and adjustments for re-billing, or write-offs based on the explanation of benefits. 
• Post payments, re-bill unpaid balances in EMR 
• Work with Bookkeeper/Finance Manager to ensure journal entries are correct. 
• Prepare billing vouchers for accounts payable, give to CEO for approval 
• Maintain filing system and electronic databases for ease of accessibility of the client’s information. 

• Provide monthly reporting for the Board of Directors as required  
• Assist with the preparation for annual fiscal audit. 
• Assist in budget development and management as requested. 
• Attends professional training wherever and whenever conducted to advance professional skills. 
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. 
• Maintain up-to-date credentials for each licensed provider, including verification through primary and secondary sources, records, and relay credentialing information to relevant personnel as needed.  
• Keeps accurate records of provider licensure/ certification renewals.  
• Other duties as assigned. 

Job Requirements: Knowledge of medical billing / collection practices required. 

 • Strong keyboard skills. • Works well in environment with firm deadlines; results oriented. • Perform multiple tasks effectively. • Able to work both independently and as part of a team. • Strong analytical skills required. • Capable of making timely, independent decisions. 

Education: Previous medical billing experience including knowledge of billing related reporting; 3 - 5 years’ experience in health-care billing & collection practices, preferably with an FQHC, • Experience working with medical payers including Medicare, Medicaid, and commercial insurance, • Working knowledge of medical billing systems, particularly eClinicalWorks, • Experience with Medicaid’s State Eligibility System, • Working knowledge of CPT and ICD-9 & ICD-10 coding systems; Coding certification preferred, • An Associate Degree from an accredited university with credentials in billing / coding preferred, • Excellent organizational skills, and • Proficiency in Microsoft Office Suite