Business Office Manager

Position Summary

Provide operational support between the facility staff, software vendor and outsourced billing company by coordinating various business office functions. These functions include (but are not limited to): Admissions/Intake, Billing, Collections, claim follow-up/denials, month end & quarterly reporting, ancillary departments and other duties as assigned.

Responsibilities

• Coordinate the Business Office team and functions to ensure operations run smoothly, efficiently and provide the best outcomes for patient satisfaction
• Directly supervise non-medical personnel, train, support, HIPAA compliance and annual evaluations
• Affirm that the facility adheres to all compliance mandates, obtains proper signatures on forms, notifications to patients and enforces Ethical Billing Practices
• Backup to all business office duties
• Ensure admission verifications and authorization procedures are carried out timely and accurately
• Act as liaison with the Admission Coordinator, Case Management, IRF-PAI Coordinator, Compliance Officer, Marketing, outsourced billing company and WellSky
• Closely work with all team members to optimize the overall operation, reporting all activities to the Corp Director, Revenue Cycle
• Closely work with the facility CEO regarding Letters of Agreement and/or Charity cases established
• Responsible for the accurate interpretation and implementation of the terms of contracts with all third-party payers
• Maintain oversight of billed, unbilled, uncoded, accepted and denied reports for all patient accounts per facility and take action on any shortfall
• Work with the outsourced billing company on accurate claim billing, payment/adjustment posting, account follow-up and appeals
• Closely work with WellSky regarding claim edits to reduce claim denials
• Review payments and adjustments applied to patient accounts to ensure reimbursement according to established contracts, CMG and/or letters of agreement
• Display competency in performing job tasks and supporting the full team
• Organize and provide website access/termination to team members needed to verify coverage, pre-authorize service, obtain payer EOB's and claim appeals
• Quarterly submit Medicare credit balance report for authorized signature
• Perform other miscellaneous administrative duties as needed

Qualifications

• Minimum of five years of experience in a medical facility (UB04 claim form) related billing environment required - IRF experience a plus
• Medical terminology knowledge required
• Experience with patient admissions, scheduling, verification of benefits, pre-certification, calculating days available per spell of illness, estimating patient out of pocket expense
• An understanding of how insurance processes work including the verification, completion of third-party liability requirements, secondary payer forms and authorizations
• Computer experience, Excel, Word, Medical Billing Software and Applications
• Must display excellent communication skills and phone etiquette. Knowledge, Skills and Ability Requirements: Excellent verbal and written communication skills, Strong organizational, time management and prioritization skills, Strong analytical and critical thinking skills, Detail-oriented, able to meet strict time frames