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The Third Party Billing Manager develops policies, procedures, and controls to ensure medical billing operations are compliant with industry standards and regulations. Plans and manages medical billing processes to ensure timely, accurate, and efficient billing operations. Being a Third Party Billing Manager continuously evaluates and optimizes processes to control department costs and adhere to budget. Validates patient billing and insurance information to verify coverage and ensure accurate calculation of charges. In addition, Third Party Billing Manager prepares routine reports to summarize revenue cycles, payments, overdue balances, and other billing metrics for management insight. Remains knowledgeable and compliant with proper medical and insurance claim processes. Needs to be familiar with ICD-10, CPT, and/or HCPCS Coding Systems as well as claim forms such as CMS-1500 and UB-04. May require a bachelor's degree. Typically reports to a director. The Third Party Billing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Working as a Third Party Billing Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes.
The Third Party Billing Supervisor implements policies and procedures to guide workflow and ensure medical billing operations are compliant with industry standards and regulations. Supervises, oversees, and administers medical billing processes to ensure timely, accurate, and efficient billing operations. Being a Third Party Billing Supervisor monitors medical billing information systems to facilitate and ensure organized and accurate records. Oversees the preparation of medical bills and invoices to verify patient insurance information and coverage and ensure the accurate calculation of provider charges. In addition, Third Party Billing Supervisor liaises with patients, medical providers, and insurance companies, resolving billing inquiries and gathering additional patient information as necessary. Remains knowledgeable and compliant with proper medical and insurance claim processes. May require a bachelor's degree. Typically reports to a manager. The Third Party Billing Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. Working as a Third Party Billing Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision.