Position Goal

This position is responsible for managing all aspects of billing, and assigned staff.

Position Responsibilities

Train and mentor billing office Reimbursement Analysts. First level contact for billing, claims resolution and leadership escalations. Establish/maintain relationships with HMMG staff members and physicians. Train new hires under assigned entity and/or specialty to include ongoing training in compliance with payor policy revisions. Manage/review/perform corrective actions for electronic or hard copy HCFA 1500 claims submissions to include all providers including those directly assigned team lead. Manage assigned Payor hold/Manager hold buckets to ensure progress towards individual and departmental goals. Appeal insurance claims as outlined by payor specific policies. Research credit balances and submit refunds based on national, state and payor policies. Travel to assigned locations as needed to provide training on accurate billing procedures Responsible for direct communication to management and staff members both internally and externally in regards to billing office procedure necessities. Provide financial reporting to management.

Direct backup to the Revenue Cycle Manager for all assigned responsibilities.

Experience:

Preferred:  Three years medical collection experience

Education: High School Diploma or equivalent required.

Special Qualifications:

Required:

C-PAR. Must be able to work independently. Knowledge of CPT and ICD-10 terminology. Must be familiar with standard concepts, practices, and procedures of this particular field. Vast understanding of State Law Medical Billing Requirements to include W/C. Must have a satisfactory Motor Vehicle Record (MVR) and valid driver’s license. Travel is required.

Preferred:

CRCR Coding certification Vast knowledge of Athena

Candidates who are hired are eligible to receive a Healthcare Financial Management Association (HFMA) membership and access to certification trainings. 

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.