Enrollment & Billing Manager jobs in Utica, NY

Description

The following section contains representative examples of job duties that might be performed in positions allocated to this job class. SDMG is a dynamic organization, and the environment can be fluid. Roles and responsibilities may be altered to accommodate changing business conditions and objectives as well as to tap into the skills and experience of its employees. Accordingly, employees may be asked to perform duties that are outside the specific work that is listed. It is not required that any position perform all duties listed, so long as primary responsibilities are consistent with the work as described. Performance standards developed for incumbents allocated to this job class may also contain relevant job content information and are referenced hereto.

• Directs efficient and effective regional business office operations and billing services to support industry best practices in the achievement of SDMG’s business objectives, internal customer service standards and SDMG’s mission and values; conducts ongoing assessment of strengths and weaknesses to understand and anticipate future needs and challenges; develops methods to streamline and improve existing processes; addresses, resolves or escalates issues/problems that are beyond the scope of authority exercised by subordinate staff.
• Manages, evaluates, coaches and motivates subordinate staff engaged in leading the ongoing regional business office activities such as: insurance billing and follow-up, account maintenance, accounts receivable/payable and related customer service activities.
• Assists with reviewing and providing input with payor contracts and incentive based programs.
• Is responsible for making employment decisions, ensuring that employees receive adequate and ongoing training appropriate to perform work assignments; counsels and coaches staff to enhance productivity; develops productivity standards, develops/communicates realistic performance standards/goals, and evaluates employee performance against standards; recommends actions such as promotions, pay adjustments, performance management and terminations within designated scope of authority.
• Responsible for change management and process for business office and billing functions during redesign and system conversions, identifying key staff to support/lead implementation and change processes. Consistently open to change and improvements in billing office and billing functions and serves as implementation champion for needed changes with staff and customers.
• Responsible for ensuring all billing office and billing policies and procedures and standards and appropriate, compliant and updated timely. Communicates policy, procedure and standard changes to providers, clinics and staff effectively and through multiple approaches, as needed.
• Responsible for ongoing education of physicians and staff on updates/changes to billing procedures, state and federal guidelines, legal regulatory requirements, and policies and procedures regarding business office functions.
• Responsible for oversight of the practice management system master tables system to ensure accurate and timely claims submission, payment posting, collections & follow-up.
• Responsible for ensuring the accuracy and integrity of the practice management system in relation to compliance standards as it relates to all regulatory billing rules.
• Keeps abreast of applicable statutory limitations, rules, regulations, standards and emerging trends impacting healthcare business office operations; ensures that regulatory updates are integrated into daily operations; develops, implements and enforces internal policies and procedures to ensure regulatory compliance, minimize risk to the organization and facilitate achievement of business objectives.
• Determines need for, and updates, reference materials such as policies, training tools, arranges for the installation of updates/changes to existing automated systems; ensures that all business office activities are fully documented in accordance with the standards and practices of the organization.
• Provides consultative advice and guidance with respect to business office policies, standards, processes and objectives to educate management, coordinate activities, promote adherence to professional standards and regulatory requirements, and to facilitate continuous improvement; participates, as a team member, in the overall management of SDMG business services. Develops and administers annual budget for assigned cost center; identifies resource needs, monitors budget variances and recommends timely corrective action to rectify or minimize adverse impact.
• Develops timely, accurate and informative financial and/or statistical reports on key performance indicators or other significant factors for review/response of executive management; may develop and deliver management presentations.

Requirements

RELATIONSHIP WITH OTHERS: Maintain and foster collaborative relationships with Physicians and staff; assistants in education and billing matters. Work collaboratively with representatives of third party agencies.

EDUCATION/EXPERIENCE/KNOWLEDGE: Five years increasing responsibility in physician billing management. 

PHYSICAL REQUIREMENTS: Requires sitting, standing bending and reaching. May require lifting up to 20 pounds. Requires manual dexterity sufficient to operate standard office equipment such as computer, fax, calculators and telephone. Requires normal hearing and vision.