Manager of Billing and Credentialing Job Chicago area,Illinois USA,Healthcare

Just a few of the Benefits enjoyed by PPIL employees:

Company subsidized premiums on Medical, Dental, and Vision Insurance
Up to 12 weeks Paid Parental Leave for eligible employees
Generous Paid Time Off (PTO) and paid holidays
Mission focused work
401k with employer matching
100% company-paid Life Insurance
100% company-paid Short- and Long-Term Disability Coverage
Robust Employee Assistance Program
Professional Development awards and opportunities
Flexible Spending Accounts
Free Medical Services at PPIL
Pet Insurance

The Manager of Billing and Credentialing is responsible for ensuring that all Health Center services are billed, collected, and reconciled, ensuring that all providers and locations are credentialed and re-credentialed, and supervising effective account receivables processes through accurate patient account maintenance, statement generation, and timely follow up. This position provides supervisory support across multiple teams that contributes to charge capturing, billing, collections and provider credentialing.

Essential

Functions

The Manager of Billing and Credentialing serves as the supervisor responsible for health center billing, Epic Workques, charge error resolution, and patient customer service and follow up. This role also serves as the Health Center point-of-contact for provider credentialing and follow up. The Manager is charged with proactively ensuring patient account satisfaction and helping ensure that Planned Parenthood of Illinois’ (PPIL) practices remain in alignment with state, federal, and payer billing compliance.

Supervises the Contracts and Credentialing Team and ensures accuracy by applying consistent technical knowledge and follow up in daily workflow processes

Supervises the Billing/Revenue Integrity Team and ensures that all services that are received are reimbursed

Serves as Revenue Cycle Management (RCM) Liaison with PPIL Vendors to resolve Billing and Credentialing scopes through timely follow up

Ensures that all Health Center services are charged and that all Pre-Bill errors are resolved daily in the Epic Workques.

Ensures that accurate notes and complete follow up statuses are listed on patient accounts.

Ensures the maintenance and updating of the PPIL Fee schedules.

Ensures the maintenance and updating of the PPIL Charge master pricing and Coding by applying consistent technical knowledge and follow up

Ensures Team compliance with State, Federal and payer rules to prevent external audits and revenue loss

Ensures timely processing and resolution of Contact Center, Vendor and patient request.

Ensures up to date documentation is maintained in the patient accounting system to meet quality assurance and productivity standards.

Serves as the Internal Project Manager for Revenue Cycle Audits and Coding Training

Assist as an RCM Payer Relations “problem solver” on all denials/revenue loss relatedtask and ensures follow up

Proactively Ensures Team PPFA Financial performance metrics are met by running EPIC BI report and monitoring Epic dashboards to ensure team guidance to prevent revenue loss

Other Functions

Proactively stays up to date on Revenue Cycle standards, Coding and Credentialing through self-initiated professional development to ensure accountability in performance of the duties of the role.

Supports and Implements the Directives of the Director of Payer Relations and Revenue Cycle Management to ensure team compliance with Department Policies and Procedures.

Coordinates with Health Center staff to ensure that all clinical documents in the EHR are received and encounters are closed daily with reconciliation.

Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows.

Facilitate training and onboarding of new teammates as well as ongoing training and education for established team members throughout the State of Illinois.

Through these activities demonstrate an understanding of and commitment to PPIL core values of access, activism, care, confidentiality, diversity, excellence, integrity, respect, self-determination, and stewardship; practice these…


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