Business Office Manager - Pediatrics - Pinson, AL

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  • Pinson, AL
  • Pediatrics East Deerfoot
  • Full-time - Day shift - 7:45a - 5:00p - Mon - Fri Rotating weekends
  • Non Clinical Professional
  • Req #: 313607
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Job Summary

Responsible for managing, directing, and coordinating the day-to-day operations of a multi-site business office including but not limited to conducting routine billing audits, month-end procedures and associated reports regarding accounts receivables/credit balances and physician production. Ensure accurate billing and appropriate reconciliation of charges and cash/insurance payment posting activities are completed in a timely manner. Collaborate with management, physicians, and office staff to insure timely and accurate communication of information.  Maintain positive interpersonal relations with physicians, staff, patients, families, manager, and COA employees.

Job Responsibilities

  • Oversee and complete the following processes and duties:  review insurance systems to determine claim status; balance due on previously billed accounts, resolve problems by phone, payor’s website, written correspondence, including coordination of benefits payable from primary/secondary payor.  Draft appeals regarding claim denials, or improper payments and requests rebilling of accounts as needed.    Respond to billing related inquiries from patients and/or insurance companies.
  • Oversee patient account collection processes and provide assistance when needed.
  • Review billing reports (EOB/ERA) to ensure proper receipt of claims, and documents records accordingly.
  • Assist with developing and implementing procedures relating to the billing office.
  • Oversee credit balances and ensure that refunds are processed timely.
  • Track and reconcile charges /payments received using automated files, manual charge records.
  • Schedule, process, and complete all EOM/EOY reconciling and reporting activities.
  • Ensure that all records, files, and copies of billing information are maintained in accordance with COA established protocol.
  • Consult with COA Accounting, Purchasing, and Auditing departments as needed. Receive and/or provide information needed to resolve billing discrepancies, order/delivery problems, and/or ensure accurate billing information has been used.
  • Maintain current knowledge of contracted insurance provider claim filing provisions and appeals procedures, and institute any changes in office procedures to accommodate new developments.
  • Communicate and educate providers, administration, managers and staff on coding and documentation guidelines, rules and regulations.
  • Conduct new employee orientation and training for business office employees, and provide ongoing constructive feedback.
  • Assist with new hire election, orientation, discipline, evaluation, and separation of billing department personnel.
  • Attend/participate in departmental meetings and bi-weekly practice team leader meetings.
  • Coordinate, process, and maintain physician’s credentialing records.
  • Ensure that insurance referrals are done in a timely manner and in accordance with the requirements of the insurance providers.
  • Support a patient first culture that fosters a high level of patient satisfaction.
  • Support a professional atmosphere and an environment of coaching and development that supports shared governance and a high level of employee satisfaction.
  • Perform other duties/tasks as required.

 

Education and Experience

  • High school diploma or equivalent required.
  • Two years of college in a business-related area preferred
  • Certification through a professional coding program e.g….AAPC or AHIMA PREFERRED
  • Three years supervisory experience in relevant medical business office preferred with an emphasis on financial/insurance related work required.  Three years of appropriate CPT/ICD coding experience required.

 

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