Manager - PFS Billing - Hybrid Work Option Available!

Kingman Regional Medical Center; Kingman (AZ); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Kingman Regional Medical Center in Arizona is seeking a CBO Billing Manager to lead hospital and clinic government and commercial insurance billing, ensuring timely, accurate payments.

The role supervises billing staff, credentialing, and clinic referrals, maintains records, and ensures HIS systems support billing processes. A strong background in CPT4/ICD9/HCPCS and Medicare reimbursement is essential.

Qualifications

• Five years’ experience in healthcare insurance billing including electronic transmission of claims.
• One year supervisory experience.

Responsibilities

• Directs the work of two or more full-time employees, with authority to hire, fire and counsel staff.
• Keeps current CPT4, ICD9 and HCPCS codes to ensure claims are paid correctly; notifies incorrect coverage and resolves billing discrepancies.
• Plans, organizes, coordinates, and controls systems for patients' billing, credentialing, and clinic referrals information.
• Monitors and evaluates the department's quality and takes appropriate action based on findings.
• Develops and revises job descriptions, interviews, and hires new staff to fill positions.
• Audits billing, credentialing, and referrals to ensure accuracy and compliance.

Skills

Billing management

Staff supervision

CPT4/ICD9/HCPCS coding

Medicare reimbursement knowledge

Analytical thinking

Education

High School Diploma or equivalent

Bachelor's degree in business or related field

Job description

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.

CBO Billing Manager is responsible for the billing of all hospital and clinic government and commercial insurance and third party payer claims in a timely, accurate manner, as required by insurance companies to effect rapid payment. The Manager supervises and coordinates activities of personnel in the billing department, credentialing, and clinic referrals. The Manager oversees the maintenance of records, files and reports in accordance with KHI standards. This position ensures that that KHI Health Information Systems are operating appropriately in relation to billing, credentialing and clinic referrals.

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 in order that claims may be paid correctly; notify credit personnel of invalid insurance or limitation of coverage; investigate and resolve any billing discrepancies; provide back-up billing assistance to billing clerks
• Works closely with other Department Managers in respect to issues that arise effecting other departments
• Plans, organizes, coordinates, and controls the systems by which patients 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 the 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 including billing
• 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 that insurance requirements are obtained as required and that insurance authorizations are effective during the admissions process; deals with insurance company provider representatives when issues effecting 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.

Date Staff Position Description Created / Revised: 10/2012; 04/2019