Job Title: Billing Manager – Medical Practice Department: Patient Accounts

Reports to: Director of Patient Financial Services Revision Date: 7/9/2024

Status: Exempt

Job Summary:

Oversight of billing processes and systems for Oswego Health Medical Practice to ensure maximization of cash collections, cost effectiveness, efficiency and to ensure work stream success. Recommends, implements and monitors department policy and procedure. Subject matter expert for billing system and clearinghouse.

Knowledge of all positions in the billing department and the ability to provide coverage for those positions when necessary.

Partner with the Finance department during the annual Financial Audit process. Partner with insurance companies to ensure payment on claims.

Oversee the hiring process, as well as timely employee evaluation processing, ongoing performance management and policy application with departmental staff.

Duties/Responsibilities:

• Oversee departmental workflow to ensure departmental efficiencies.
• Oversight of employee schedule to ensure adequate departmental coverage.
  • Dissemination of any pertinent updates to the billing staff.
  • Update month end spreadsheets to review with staff
  • Review and approve employee time cards.
  • Coordinate monthly staff meetings.
  • Develop competencies and ensure departmental trainings are completed by staff.
• Monitor key performance indicators including A/R Aging, A/R days, Aging by insurance, clean claim rate, and denial rates
• Develop process to ensure all denials are reviewed and responded to including disseminating to other departments and working to develop processes to improve denial rate.
• Facilitate regular meetings with Insurance Companies, ensuring all claims are being processed accurately, and addressing issues/concerns in a timely manner.
• Collaborate with outside vendors- including credentialing service and collection agency.
• Coordination of the flow of information between the billing department and operational leadership
• Maintain knowledge of state, federal, and contracted third party regulations for billing and reimbursement for all payers.
• Perform other duties as assigned.

Required Skills/Abilities (Unit Specific):

• Excellent verbal and written communication skills as well as interpersonal skills.
• Proficient in standard computer programs, including Microsoft Office Suite (Excel, PowerPoint, and Word).
• Excellent time management skills with a proven ability to meet deadlines.
• Professionalism and business acumen appropriate for working with guests, clients, physicians, employees and volunteers.
• Proactive and independent, with the ability to take initiative.
• Familiarity with laws, regulations, and best practices applicable to billing practices.

Education and Experience:

Must be a high school graduate, have healthcare and insurance knowledge in relation to the billing and collection process and prior billing office supervisory experience. Must have knowledge of billing office operations, experience in billing, credit and collections and follow-up. Must have good communication skills to convey billing and financial policies. 5 Years of billing and follow-up experience required in addition to 5 + years supervisory experience preferred.

Working Conditions:

• Extended periods of sitting, using standard office equipment including, but not limited to: computers, phones, scanners, fax machines, printers, etc.
• Occasionally requires assembling, using and maintaining all departmental equipment.
• Occasionally requires prolonged periods of standing and walking with the ability to lift, push or pull up to 15 lbs. using proper body mechanics.
• Attendance ensures that job requirements are met.
• Actively participates in Quality Assurance programs and CQI, in-service programs, cross-training; completes department specific requirements/competencies; attends all mandatory classes as required; participates in meetings and committees as assigned.
• Complies with DOH requirements for annual health assessments and required immunizations.

Pay Range: $65,250-$75,750/annual

Employee salary is based on commensurate experience and other qualifications.

The mission of Oswego Health is to provide accessible, quality care and improve the health of residents throughout Oswego County. As a nonprofit healthcare system that was established in 1881, Oswego Health is proud to continue to be one of Oswego County’s largest employers. More than 1,200 employees spread throughout its 17 locations, work for the Oswego Health system, which includes the 164-bed community hospital with a brand new Medical Surgical Unit, a 32-bed state-of-the-art psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community. The health system also operates Oswego Health Home Care, the only hospital-based certified home healthcare agency in the County as well as two outpatient centers, including the Fulton Medical Center, offering urgent care, lab, medical imaging, physical therapy, and occupational health services; and the Central Square Medical Center, offering urgent care, lab, medical imaging, and physical therapy services. In addition, Oswego Health includes the Oswego Health captive professional corporation, Physician Care P.C., providing physician services in orthopedics, cardiology, ENT, gastroenterology, breast care, audiology, general surgery, bariatrics, and primary care.

EQUAL EMPLOYMENT OPPORTUNITY

Oswego Health is committed to providing equal opportunity in all employment-related matters, without regard to race (including traits historically associated with race), creed, color, religion, sex/gender, national origin, age, marital or familial status, disability, pregnancy-related condition, sexual orientation, gender identity, gender expression, transgender status, citizenship status, ancestry, arrest/conviction record, military or veteran status, domestic violence victim status, genetic predisposition or carrier status, reproductive health decision making, relationship or association with a member of a protected category, or any other legally protected characteristic. Decisions affecting your position including, but not limited to, recruitment, hiring, placement, promotion, transfer, compensation, benefits, training, tuition assistance, leaves of absence, disciplinary action, layoff/recall, and terminations will be made in accordance with this policy.