As the Billing Manager for Swope Health's Finance department, you will be part of a top-tier finance and accounting team that helps the organization reach its financial goals. The Billing Manager will work directly with the Sr. Director of finance in supervising functions and activities performed by the Billing Department for assigned department/divisions, including accurate and timely filing of claims, processing of remittance advices, and claims denial management.
Primary Responsibilities:
- Update and implement policies and procedures for functions performed by the Billing Department for assigned departments. This includes remittance advice processing and reconciliation, insurance refund processing, write-offs, managing timely filing of claims, and auditing accuracy of payments against expected payments and fee schedule maintenance.
- Manage interdisciplinary team relationships for improvement in billing and collection processes with assigned departments.
- Supervise the update and accuracy of insurance plan information and communicate changes in billing process and procedures to staff impacted.
- Maintain a weekly work schedule for billing staff and coordinate with the Sr. Director of Finance.
- Train and cross-train for functional responsibilities with the Sr. Manager- Primary Health Claims.
- Hire and train all direct reports, assuring they understand and demonstrate competence in all department policies and procedures.
- Monitor and resolve clearinghouse issues.
- Prepare and report monthly accomplishments against departmental goals.
- Identify root causes for denial of claims and work with respective providers/departments to improve denial rate.
- Participate, monitor, and lead changes in Commercial or Medicaid claim submission and related billing guidelines for dental services.
- Participate in billing committee meetings as needed related to claims process.
- Satisfactorily complete all training sessions and adapt to present and new departmental policies and procedures in a reasonable time period.
- Comply with computer security guidelines.
- Other related duties as assigned.
Successful Candidates Will Have:
- Associate degree in accounting, business or related field. Bachelor's degree in finance accounting or related field preferred. Or 3 years or more experience in claims processing.
- Must have working knowledge of funding sources and regulatory issues impacting health care billing and collection functions.
- Ability to relate and communicate with a wide range of staff and across various departments.
About Swope Health Services:
Each year, Swope Health serves over 45,000 patients, encompassing more than 200,000 visits in four counties on both sides of the state line. Our team members are proud of the work we do and the promise we've made – delivering coordinated care that values the needs of the whole person and championing better health in our community.
Swope Health is a special place that cares for the people who need it most, wherever they are in the community. As part of our promise to battle health inequities and provide high-quality, comprehensive care, we make care visible. That means we proudly deliver our promise through every action, every day.
Swope Health Services supports its team members with:
- Medical benefits (including a Health Savings Account option), dental and vision.
- 401(k) retirement plan with company match.
- Company-paid benefits such as life insurance, Accidental Death & Dismemberment, and Short- and Long-Term Disability.
- Flexible Spending Account.
- Paid Days Off beginning at 12 days annually, effective the first day of employment.
- Eight annual company-paid holidays; One annual paid personal day.
Swope Health is an affirmative-action, equal-opportunity employer. We consider all qualified applicants without regard to race, color, creed, religion, gender, national origin, age, marital status, veteran status, or disability.
Education
Required:
- Associates or better in Accounting or related field.
