Billing Manager

Company: KIDNEY SPA LLC
Location: Miami
Posted on: May 27, 2023

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