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
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.
- 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.