Medical Billing Manager - Santa Monica, United States - Santa Monica Eye Medical Group
Description
Position:
Medical Billing Manager - Ophthalmology
Location:
Santa Monica, CA
Schedule:
Full-Time, Part-Time, and Flex-Time positions
Salary:
Competitive Salary & Bonus Program
Benefits:
Health, Dental, Vision, EAP, 401(k), Costco, AAA
ABOUT US
Since 1948, patients from throughout the greater Los Angeles area have found cutting-edge eye care at the Santa Monica Eye Medical Group, located in Santa Monica, California.
Sadiqa Stelzner, associate professor at UCLA, the doctors at the practice offer not only state-of-the-art eye care ranging from advanced surgical procedures including laser refractive surgery (LASIK), refractive laser-assisted cataract surgery (ReLACS), and micro-invasive glaucoma surgery (MIGS) and exams for glasses and contact lenses.
We also specialize in a variety of aesthetic treatments to address scars, wrinkles, stretch marks, melasma, etc. As another convenience to our patients, we have on-site a state-of-the-art outpatient surgery center (ASC).Today, Dr. Stelzner and her colleagues offer state-of-the-art treatments and compassionate patient care.
They understand that the gift of sight changes lives, so they take the time to get to know their patients, listening to their concerns and experiences while also providing excellent care and medical treatment.
As a part of our team, you will be welcome to work with us for years to come as we do outstanding work serving our patients.
JOB BRIEF
The Medical Billing Manager is a full-time position responsible for overseeing the billing and coding staff and making day-to-day decisions, understanding and coding all procedures within regulatory mandates, assisting with following up on insurance claims, and submitting appeals as needed.
This position is responsible for directing and coordinating the overall functions of the billing and coding office to ensure the maximization of cash flow while improving patient, physician, and other customer relations.
The Medical Billing Manager is responsible for billing all third-party payers, claims processing, payment posting, aged claim resolution, and charge posting.
This position generally works normal business hours Monday-Friday 8:00-5:00, with flexible schedules available.A pleasant, warm and professional demeanor is essential.
As a member of our team, we all provide a high level of efficient patient care, while always presenting a caring, ethical, friendly, and professional experience for the patients.
***ESSENTIAL RESPONSIBILITIES
- Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable followup, and reimbursement management.
- Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
- Serves as the practice expert and goto person for all coding and billing processes.
- Analyzes billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
- Follows up on claims using various systems, such as Nextech EHR, TriZetto clearinghouse, etc.
- Maintains contacts with other departments to obtain and analyze patient information to document and process billings.
- Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the CFO and Practice Manager. Collects and compiles accurate statistical reports.
- Keeps up to date with carrier rule changes and distributes the information within the practice.
- Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Director of Operations.
- Successfully scrubs and QC's claims prior to submission.
- Manages the A/R, works rejected claims, and provides necessary followup to ensure successful claim processing.
- Posts insurance and patient payments, ensuring all posting is live in the system.
- Maintains strong attention to detail and ability to multitask.
- Maintains extremely high standards of professional conduct.
- Establishes and maintains effective working relationships with the office staff and Doctors.
- Adheres to policies regarding safety, confidentiality, and HIPAA guidelines. Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
EDUCATION AND EXPERIENCE
- Minimum 3+ years experience in Ophthalmology and Optometry.
- Experience with ASC
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