Billing Manager
Company: KIDNEY SPA LLC
Location: Miami
Posted on: May 27, 2023
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Job Description:
Description:About KidneySPA Health Centers,We inspire, empower
and enhance the lives of our patients, through education,
individualizes care, and fear-free treatment in a nurturing and
relaxing environment that can only be experienced at
KidneySPA.Philosophy:We understand that true healing happens when
the patient is comprehended in its whole dimension: Mind, Body &
Spirit.Mission:We believe the rejuvenation of mind, body, and
spirit is essential to increase life expectancy and general
wellbeing. Our team of dedicated doctors, nurses, coaches and
highly skilled technicians all operate under the same central
philosophy that wellness begins with hospitality. We provide the
finest and specialized care to every patient treated under our
services.KidneySPA Culture?:We embrace quality, professionalism,
harmony, caring, friendly environment & commitment.? We see
dialysis from a different perspective, to offer a unique patient
experience.? We provide the finest specialized care to every
patient that walks through our doors.The Billing Manager reports to
the CFO and provides supervision to the billing department with all
medical collections and insurances. The Billing Manager will be the
expert in the setup and use of electronic billing system,
intermediary billers, and clearinghouse portals. The Billing
Manager will maintain and manage all billing system parameters to
ensure accurate, timely submission.ESSENTIAL JOB FUNCTIONSAcquires
and maintains a current working knowledge of billing practices and
changes in behavioral health reimbursement and billing
procedures.Determine prior authorization requirements for each
service/payor and establishes procedures to obtain prior
authorization.Work EOBs and Remittance Advice for Medicaid,
Medicare, commercial and managed care insurance.Work rejected and
denied claims, correct claims, and rebill within guidelines.Develop
and maintain liaison with third party guarantors to keep current on
payment rules and procedures in order to maximize the Center's
ability to access payment from these guarantors.Lead and supervise
the staff completing day-to-day operations involving third
party/patient billing, follow-up and payment/adjustment batching,
and posting.Provides training, orientation, and annual performance
evaluations for assigned staff.Act as administrator for payer
website/log in access.Create and maintain the process of obtaining
enrollment and credentialing of providers.Develops, implements,
monitors and evaluates quality assurance activities, ensuring
compliance with standards, laws, regulations and procedures.
Recommends new and/or revised policies and procedures as
needed.Answers questions from patients, clerical staff, and
insurance companies. Identifies and resolves patient insurance and
billing issues.Performs various collection actions including
correcting and resubmitting clean claims to secondary payers.
Processes payments from insurance companies.Works closely with
Social Worker to assure that all resources have been explored for
financial needs.Maintains electronic folders of insurance carrier
EOB's and patient payments.Can identify and troubleshoot electronic
transmission issues and takes corrective action directly with the
Electronic Clearinghouse.Additional duties as needed.EXPERIENCE AND
REQUIRED SKILLS:Requirements:QUALIFICATIONS AND REQUIRED SKILLS:An
Associate degree from an accredited university with credentials in
billing and coding preferred or an Associate or bachelor's degree
in accounting or Business Administration.Previous medical billing
experience including knowledge of billing related reporting; 3 - 5
years' experience in health-care billing and collection practices.
Use of Gaia EMR and Billing system is a plus.Experience working
with medical payers including Medicare, Medicaid, and commercial
insurance.Working knowledge of medical billing systems.Experience
with Medicaid's State Eligibility System.Working knowledge of CPT
and ICD-9 & ICD-10 coding systems.Excellent organizational skills,
and --- Proficiency in Microsoft Office Suit.Works well in
environment with firm deadlines; results oriented.Perform multiple
tasks effectively.Able to work both independently and as part of a
team.Strong analytical skills required. --- Capable of making
timely, independent decisions.WORK ENVIRONMENT AND PHYSICAL
REQUIRMENTS:Inside and sedentary, requires sitting for long periods
of timeWork is performed in an office setting.Physical demands of
position: sitting, standing, walking, typing, phone communication,
face to face conversation.
Keywords: KIDNEY SPA LLC, Miami , Billing Manager, Accounting, Auditing , Miami, Florida
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