Essential Responsibilities Manage daily physician billing operations, including charge processing, claim submission, payment posting, A/R follow-up, denials, and account resolution. Supervise, train, coach, and evaluate physician billing staff; monitor productivity, quality, and workload. Monitor key performance indicators, including days in A/R, aging, denial rates, clean claim rates, charge lag, collections, and staff productivity.
Analyze denial and reimbursement trends and coordinate corrective actions with coding, registration, authorization, clinical departments, and payers. Research and resolve complex Medicare, Medicaid, Medicare Advantage, and commercial payer billing issues. Ensure billing activities comply with CMS, payer, HIPAA, and organizational requirements.
Assist with development and maintenance of billing policies, procedures, workflows, claim edits, and departmental controls. Support revenue cycle system configuration, testing, upgrades, and implementation of new providers, clinics, and services. Collaborate with physicians, practice leadership, Finance, Coding, IT, Compliance, and other departments to improve revenue cycle performance.
Assist the Director with reporting, budgeting, staffing, audits, strategic initiatives, and special projects. Serve as departmental leader and decision-maker in the Director’s absence.