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Responsibilities
The Billing and Posting Resolution Advocate is responsible for overseeing claims production, billing, follow-up, collections, and compliance with third party payer regulations.This position is responsible for daily oversight and management of process-based revenue cycle functions, including ongoing improvement to key revenue cycle indicators. These indicators include but are not limited to: A/R days, cash collection goals and posting, denials, underpayment and contract management activities related to patient account management.The Billing Manager should have comprehensive knowledge of revenue cycle operations.Essential FunctionsPossess complete understanding of the billing/collection process to resolve complex, outstanding claims.Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.Provides operational oversight for the Billing Coordinator, mentoring them in their responsibilitiesMaintains current knowledge of hospital billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practicesDemonstrates ability to manage, train and motivate employees, as well as a professional attitude in relating to executive management, professionals and third-party insurance carriers.Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessaryPro-active communication/escalation of potential claims/unbilled accounts/issues to the DirectorExhibits excellent leadership and self-direction, good judgement in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills.Assures that confidentiality of patient information is maintained without exceptionAttends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices.Liaise with facility management and operates as the lead point of contactMaintain employee time and attendance and scheduling demandsResponsible for accuracy of customer invoices, and creating the invoices monthlyUnderstanding the contract terms and insuring we stay within those termsPerforms all functions from the Management Expectations ListPerforms all other duties assignedMinimum RequirementsHigh school graduate or GED equivalent3 years previous hospital billing experienceWorking knowledge of insurance regulations, procedure and diagnosis coding and automated insurance billingExcellent communication (written and oral) and interpersonal skillsExcellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow throughMust be able to work through issues to resolutionPreferred QualificationsAssociates or Bachelor’s Degree2 years Medicare hospital billing experience
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