Billing and Posting Resolution Advocate

The Billing and Posting Resolution Advocate is responsible for overseeing claims production, billing, follow-up, collections, and compliance with third party payer regulations. This position is responsible for daily oversight and management of process-based revenue cycle functions, including ongoing improvement to key revenue cycle indicators. These indicators include but are not limited to: A/R days, cash collection goals and posting, denials, underpayment and contract management activities related to patient account management. The Billing Manager should have comprehensive knowledge of revenue cycle operations. The position is responsible for personnel development and initiating disciplinary action according to policy.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
• Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.
• Provides operational oversight for the Billing Coordinator, mentoring them in their responsibilities
• Maintains current knowledge of hospital billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practices
• Demonstrates ability to manage, train and motivate employees, as well as a professional attitude in relating to executive management, professionals and third-party insurance carriers.
• Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.
• Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary
• Pro-active communication/escalation of potential claims/unbilled accounts/issues to the Director
• Exhibits excellent leadership and self-direction, good judgement in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills.
• Assures that confidentiality of patient information is maintained without exception
• Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices.
• Liaise with facility management and operates as the lead point of contact
• Maintain employee time and attendance and scheduling demands
• Responsible for accuracy of customer invoices, and creating the invoices monthly
• Understanding the contract terms and insuring we stay within those terms
• Performs all functions from the Management Expectations List
• Performs all other duties assigned

Minimum Requirements:

Education/Experience/Certification Requirements

• High school graduate or GED equivalent
• 3 years previous hospital billing experience
• Medicaid billing
• Working knowledge of insurance regulations, procedure and diagnosis coding and automated insurance billing
• Excellent communication (written and oral) and interpersonal skills
• Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow through
• Must be able to work through issues to resolution

Preferred Qualifications:

• Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
• Recommends new processes and changes in current processes.
• Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures.
• Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts.
• Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements.
• Responsible for consistently meeting production and quality assurance standards.
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
• Updates job knowledge by participating in company offered education opportunities.
• Protects customer information by keeping all information confidential.
• Processes miscellaneous paperwork
• Ability to work with high profile customers with difficult processes.
• May regularly be asked to help with team projects.
• Responsible for assisting manager in the management of employees which would include coaching, training, and performing necessary disciplinary actions including following up on action plans for their employees.
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
• Ensures employee compliance with dress code, attendance, and other company policies.
• Processes miscellaneous paperwork and performs other administrative duties as assigned.
• As a Billing and Posting Resolution Advocate you will also need to:
• Fill-in as a Biller where needed.
• Must be agile and able to easily shift between tasks.
• Assist with backlog billing projects, such as advanced claim resolution.
• Assist with new contract implementation.
• Review claims to ensure edits are setup correctly.

Why join our team?

If you join us, you will receive:

• Work remotely with a work/life balance approach
• Robust benefits offering, including 401(k)
• Generous time off allotments
• 10 paid holidays annually
• Employer-paid short term disability and life insurance
• Paid Parental Leave