Manager - PFS Billing - Hybrid

Azkrmc; Kingman (AZ); On-site; USD 65,000 - 90,000; Full time

Job summary

Azkrmc in Arizona is seeking a CBO Billing Manager to lead the Patient Financial Services billing team, ensure accurate electronic claims, and maintain coding compliance. The role requires supervisory experience and a strong understanding of Medicare reimbursement processes.

You will direct daily activities, collaborate with department managers, and drive process improvements to optimize cash flow and service quality.

Qualifications

• Education: High School Diploma or Equivalent.
• Experience: Five years in healthcare insurance billing and one year of supervisory experience.
• Experience with electronic transmission of claims.
• Supervisory experience.
• Knowledge of CPT4, ICD9 and HCPCS coding.

Responsibilities

• Direct the work of two or more full-time staff with hiring and disciplinary authority.
• Notify and advise on CPT4, ICD9, and HCPCS coding changes to ensure proper payments.
• Collaborate with other department managers on cross-department issues.
• Plan and control systems for patient billing, credentialing, and referrals.
• Monitor quality and take action based on findings.
• Develop and revise job descriptions; hire replacements as needed.
• Coach staff and administer policies; manage scheduling and appraisals.
• Provide staff development through orientation and training; stay current on billing trends.
• Coordinate community education programs and respond to physician requests.
• Assess volumes; set goals and evaluate achievements annually.
• Audit billing, credentialing, and referrals; ensure insurance requirements and authorizations.
• Develop and implement department policies and procedures.

Skills

Staff management

Typing

Numerical ability

Public interaction

Resource organization

Medicare reimbursement knowledge

Education

High School Diploma or Equivalent

Bachelor degree in business or related field

Job description

Position Title: CBO Billing Manager Position Code: MgrCBOBi-8115

Department: Patient Financial Services

Safety Sensitive: Yes

Reports to: Assistant Director, Patient Financial Services

Exempt Status: Yes

This position is Hybrid available to Arizona Residents Only - incumbents must reside within the state of Arizona and within 3 hours of Kingman, AZ

Qualified Candidates Must Have

Education: High School Diploma or Equivalent

Experience: Five (5) years’ experience in all types of (healthcare) insurance billing including electronic transmission of claims and one (1) year supervisory experience

Skills and Knowledge

• Manages staff through positive reinforcement that motivates and instills confidence
• Typing and computer experience
• Verbal and numerical intelligence
• Ability to interact with the public
• Ability to motivate people and utilize resources in an organized manner
• Understanding of Medicare reimbursement

Position Purpose

All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision of providing the region’s best clinical care and patient service through an environment that fosters respect for others and pride in performance.

Key Responsibilities

• Regularly directs the work of two or more full time employees. Has authority to hire, fire and counsel staff. Interviews and selects personnel, recommends promotion, disciplinary action, and termination of employees as needed. Handle employee complaints and grievances.
• Keep current and advise billers of all changes of CPT4, ICD9, and HPCS codes to ensure claims are paid correctly; notify credit personnel of invalid insurance or limitation of coverage; investigate and resolve billing discrepancies; provide backup billing assistance to billing clerks.
• Works closely with other Department Managers regarding issues that affect other departments.
• Plans, organizes, coordinates, and controls the systems by which patient billing, provider credentialing, and clinic referrals information is developed, processed, and maintained.
• Monitors and evaluates the quality of the department and takes appropriate action based on findings.
• Develops and revises job descriptions for all department positions; interviews, selects and hires new or replacement staff to fill approved positions.
• Effectively utilizes employee improvement and corrective action methods when necessary; schedules work hours and assignments for employees to meet the needs of the Department’s customers; administers hospital and department policies and procedures; completes employee appraisals.
• Provides opportunities for self and staff development through orientation, education, and training; maintains professional qualifications and remains abreast of current developments and trends in billing and reimbursement processes.
• Provides/coordinates community and education programs as needed; responds to physician requests and the Medical Staff personnel.
• Assesses current volumes, and projects/plans for future service needs; establishes operational goals and objectives; evaluates achievements at least annually.
• Randomly audits billing, credentialing, and referrals using sampling techniques to ensure accuracy; coaches employees for improvement where necessary based on predetermined parameters; ensures insurance requirements are obtained as required and that insurance authorizations are effective during the admissions process; deals with insurance company provider representatives when issues affect cash flow arise.
• Develops and implements policies and procedures for the department.

Preferences

• Education: Bachelor degree in business or related field
• Experience: Preferably in a hospital or similar institution

Special Position Requirements

Blood Borne Disease Exposure Category: Category III

Work Requirements

Ability to sit for six to seven hours daily at a computer terminal; occasionally lifts and carries up to 15 pounds of files to storage area.