Manager - PFS Billing - Hybrid

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

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

• 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

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.

• 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.

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

Blood Borne Disease Exposure Category:
Category III

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.