Manager Patient Financial Services

Manager Patient Financial Services
Decatur, GA



The Billing Manager is primarily responsible for assuring that clear lines of authority, communications and delineation of all customer jobs have been established and assigned. The Manager will ensure that the department is operating within approved budgetary constraints and overseeing all applicable job functions as stated in organizational and departmental policies and procedures. Ensure yearly departmental goals and objectives are established as well as participate as a team member in meeting objectives and goals.


The Manager will be responsible for understanding, implementing and educating all Government Regulatory changes for Billing and Compliance and will be responsible for annual updates. The Manager will be responsible for the Medicare and Medicaid quarterly credit balance reporting. The Manager will be proficient in the Florida Shared system. The Manager will understand the Medicare RAC process and coordinate with the RAC staff for appropriate billing. The Manager will have an in-depth understanding of billing edits and edit resolution. The Manager will be responsible for providing educational programs and disseminating information to staff and departments and to co-chair committees. The Manager will interview and select employees to assure they are qualified and will interact well with current employees. The Manager is responsible for keeping informed of new changes in third party regulations, resolving ways to work within any new regulation and coordinating any testing or move to production efforts as it applies to billing functions. Ensure all billing/payor edits are continually updated and ensures personalized handling of patient accounts while maintaining sound and efficient business practices. The Manager will also maintain appropriate files, reports and other statistical data as required and provide results of all special projects and provide recommendations for additional revenue opportunities.


Coordinates re-bills and adjustments of accounts based on hospital audit results. Manage all types of AR billing while guiding billers and collection specialist with an organized method to achieving maximum collections.

The Billing Manager will work closely with all Patient Accounts staff, Patient Access Staff, Contracting and Process Improvement, Revenue Cycle Division staff, Medical Records staff, hospital staff, patients and physicians and their staff. The Manager will coordinate activities with other departments and is expected to demonstrate, through plans and actions, that there is a consistent standard of excellence

Essential Functions of Role:

1. Sets monthly goals and provide data to Director of Patient Financial Services along with any accomplishments.
2. Evaluates performance standards of the staff under direct supervision.
3. Ensures that the department is operating within approved budgetary constraints.
4. Responsible for all billing upgrades, testing, interfaces, reports for E-Premis,and Eclipses. Documents all patients’ accounts clearly and concisely of all activity
5. Responsible for managing vendor relations that pertain to Medicare and billing and overseeing and coordinating the processing for Medical Necessity and Correct Coding Initiative requirements.
6. Oversees that claims and filed timely and are correct, oversee the process of working claim rejections and monitors daily and oversees the process of entering late charges and credits.
7. Manages billing backlogs and develop corrective action plans.
8. Oversee the error correction process, oversee secondary billing and meets standards established and monitor applicable job functions as stated in the Policies and Procedures.
9. Monitor and take action necessary for aged accounts.

Minimum Qualifications:

 Bachelor’s Degree, Master’s preferred.
 3-5 years Medicare, Medicaid and Insurance Billing experience.
 2-3 years managerial billing experience and/or CMPA certification required.
 In depth knowledge of Government billing regulations and guidelines
 In depth knowledge of billing edit resolution
 Ability to conduct regular staff meetings to provide effective communication to staff and troubleshoot concerns.
 Assures that each employee is directed in the responsibilities of their particular task.
 Applies corrective disciplinary action when necessary.
 Follows correct Human Resource Policies in dealing with new hires.
 Maintains current job descriptions and procedures.
 Demonstrates a willingness to be helpful, courteous, and responsive to all customers including but not limited to employees, patients, physicians and guests.
 Maintains records of time and attendance of employees under supervision.
 Maintains file, reports and other statistical data as required.

Reports to: Director of Patient Financial Services

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