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Medical Billing Manager- Allowables in Akron, OH at TeamHealth

Date Posted: 4/9/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Akron, OH
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    4/9/2019

Job Description

JOB DESCRIPTION OVERVIEW:

The Allowables Manager is responsible for managing processes to insure appropriate action is taken to identify, report, resolve, and prevent, whenever possible, under and over allowed claims. The Manager is directly responsible for the day-to-day activities of Allowables Department, assuring that work is handled in an efficient and effective manner including staffing, hiring, disciplinary action, training and assurance of conformance to policies by assigned personnel.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Interfaces with Patient Accounts Manager regarding under and over allowed claims and payer trends.
  • Interface with managed care departments to confirm accuracy of contracts and contract rates in pricing module.
  • Review and monitor all daily, weekly, and monthly allowable reports.
  • Communicate and coordinate action plan for resolution with payer to include report submissions, appeals, and prevention methods.
  • Insure that any settlements/additional payments received from payers are presented to Patient Accounts with clear direction and documentation for posting.
  • Participate in meetings with various billing center or corporate leaders to discuss trends, standardized process, and high level resolution methods.
  • Monitor progress of Allowables Representative to insure resolution to under and over allowed claims is realized, especially on high-volume payers.
  • Attends monthly Billing Center/Division meeting conference calls and reports on status of under and over allowed claims.
  • Other duties as assigned by VP of Billing Center
  • Communicate with BC Management on the progress of projects and assignments 

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • 3-5 years previous supervisor / management experience
  • Demonstrated knowledge of physician billing and healthcare reimbursement
  • Ability to prioritize workload to meet scheduled deadlines
  • Good verbal and written communication skills
  • Good analytical skills
  • Personal computer skills, experience with Microsoft Excel
  • Minimum high school diploma; BS or BA preferred or equivalent management/supervisory experience in physician billing related field
  • Additional training in Accounting preferred
  • Ability to deal with a variety of tasks simultaneously in a fast paced environment and establish and orchestrate priorities while maintaining a professional demeanor
  • Demonstrate sound judgment and leadership skills
  • Knowledge of IDX/BAR preferred
  • Proven record of outstanding professional accomplishments in medical and physician billing as its primary environment
  • Extensive knowledge of reimbursement, allowables, and contracting

SUPERVISORY RESPONSIBILITIES

  • Manages Allowables Representatives

PHYSICAL / ENVIRONMENTAL DEMANDS:

Set in a pleasant, high-volume, fast-paced office environment. Ability to meet closing deadlines and production standards is required. Involves extensive computer use.

Must be available to work extended hours in order to get the job done as needed.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work additional hours beyond a regular schedule and/or more than five days per week.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

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