Billing Manager

East Carolina University

$34.602 - $56,422

medical insurance

United States, North Carolina, Greenville

Sep 14, 2024

Position Details

Position Information

Job Title	Billing Manager
Position Number	921725
Vacancy Open to	All Candidates
Time-Limited	No
Department Homepage	https://studenthealth.ecu.edu/
Advertising Department	STUDENT HEALTH SERVICE
Division	Student Affairs
Classification Title	10422 Admin Support Specialist
Competency Level	3 - Advanced
Working Title	Billing Manager
Number of Vacancies	1
Full Time Equivalent (FTE)	1.0
Full Time or Part Time	Full Time
Recruitment Range	$34.602 - $56,422
Anticipated Hiring Range	$50,831 - $53,375
Salary Grade Equivalency	GN08
Work Schedule	Monday-Friday
Work Hours	8:00am - 5:00pm
Position Location (City)	Greenville
Job Category	Staff - Office/Clerical
Organizational Unit Overview	The Division of Student Affairs comprises over 30 departments, each responsible for providing various student support, services, and educational programs accessible to the university community. With over 300 full-time employees and over 1200 student workers, the Division supports Pirate success through environments that enhance student development, engagement, belonging, well-being, and career readiness. The Division strives to be a national leader in developing student experiences that positively transform lives and communities through work that makes students the focal point of our services, policies, and programming; creates a community where all feel safe, included, and welcomed; treats each other with dignity and civility, and recognizes every individual has rights, ideas, and beliefs; maintains open and honest interactions, and delivers high-quality programming, services, and resources through continuous reflection and improvement.
Job Duties	The Billing Manager will oversee the entire third-party insurance filing process, reconciliation of patient accounts and interdepartmental billing. This position will also submit claims and serve as a subject matter except for carrier policies, procedures and practices. Duties include ensuring electronic claims are submitted per policy, correcting coding, following up on pending/denied claims, identifying coding trends, monitoring contracts. This position will also oversee the insurance and cashier staff. This position leads the third-party insurance filing process and is expected to serve as the subject matter expert for insurance coordinators; including supervision/oversight of coordinators and cashier staff. Position will educate clinical staff on current coding and documentation guidelines; which will require developing policies for clinical and billing staff, will prepare required AR reports for Director of Business Services to review and submit; also will be expected to analyze financial reports to identify coding and billing trends. Insurance Credentialing, Filing, Reports and Collections: Responsible for the initial credentialing and maintenance of credentialing for all SHS providers with various third-party insurers. Oversee the entire third-party insurance filing process for all carriers. Work with Business Manager, carriers to author claim policies and procedures. Monitors duties of, patient accounts billing staff, Learns key duties of all staff. Assigns staff schedule for insurance eligibility verification, claims processing and pending claims by carrier. Creates claims daily, corrects errors and submits claims daily. Identifies any coding errors or IT issues that need to be resolved. Reports any delays or problems that may affect cash flow of the operation to the Business Manager. Monitors Explanation of Benefits. Reviews monthly aging analysis by insurance group and by patient to identify outstanding accounts receivable. Research insurance carrier denials of claims, submit additional information as needed. Post Electronic Remittance Advice (ERA) as well as paper checks from carriers. Monitor weekly transfer of charges to the bursar office. Identify coding trends that do not support maximum reimbursement. Makes recommendations that will prevent or correct coding errors. Provide training to staff re: coding. Monitors scanned new insurance card information as well as incomplete patient insurance information. Advises senior management on potential contract issues with potential new in-network insurance carriers. Monthly Deceased Students Report - contact parents/emergency contacts of students that are deceased but were covered by the student health insurance plan at the time of death. Billing: Serve as a subject-matter expert for physicians, insurance carriers and patients to resolve questions/problems pertaining to patient accounts. Evaluates accounts, billing, payments, coding and posting of accurate charges for a complex medical facility. Evaluates and provides guidance for price structures. Monitor all billing duties of patient accounts staff to ensure work is current. Cross train billing staff to perform key functions of the department. Initiates and monitors IDT for various on campus department re: clinical services. Assist Director of Business Services in planning, developing and promoting effective patient service improvements. Provides weekly, monthly and annual A/R reports to department's Director of Business Services. Analyze financial reports to identify coding/billing trends. Personnel Management: Responsible for recruiting, hiring, training, establishing work standards, completing annual reviews and competencies for Patient Accounts staff. Counseling all departmental employees in compliance with University policies and procedures. Responsible for assuring the competencies of employees in accordance with requirements and to promote quality service. Encourage and support professional and personal development plan for staff. Assure that the policies and procedures of the Performance Management System are administered fairly and consistently. Pharmacy Reconciliation: PCI Device Tampering Logs. Resolve Payment Exceptions. Revenue Deposit. Receive Checks - Verify that checks received are for pharm, log the checks in our check record, verify deposits. Log detail from the attached remittance into the SHS Pharm Detail Log, mark checks received in Pharmacy First Recon Portal. Manage Store Detail - Reconcile all remittances received for Pharm against report from NRX with the prescriptions run for the month to verify that all prescriptions billed to the insurance have been paid to us. Track Store Detail vs Paid Claims vs Monthly Losses. Manage losses and attempt to correct, if possible, work with pharmacy team to re bill claims if needed. Interdepartmental Transfers for Billing/Changes to Departments. Aging Summary. Multiple reports in QS1 to capture numbers mentioned above including "Auto Posting" - this is what allows the charges to even show on charge accounts. Trains pharmacy staff on POS system enhancements. Maintains and updates pharmacy billing and deposits per policies an processes. Accreditation Standards: Complies with regulatory standard. Maintains standards for computer security and complies with Campus Health Computer use policies. Completes Annual Health & Safety, Age Competency and HIPPA trainings. Communication: Communicates problems, issues and concerns to proper channels. Promotes open relations and teamwork. Collaborates and serves as resource with UNC system partners to enhance billing and structure for ECU and System policies. Participate in Orientation sessions for Athletes, Medical Students, Freshman, etc. Communicate current coding and documentation guidelines to clinical staff. Develop billing and coding policies for clinical and billing staff.
Minimum Education/Experience	High school diploma or equivalency and one year of related office experience; or equivalent combination of training and experience.
License or Certification required by statute or regulation	None
Preferred Experience, Skills, Training/Education	Experience filing and processing medical insurance claims from an Electronic Medical Record system through a clearinghouse to carriers. Supervision experience
License or Certification required by the Department	None
Special Instructions to Applicant	Please ensure your full range of knowledge, skills, abilities, experience and education are listed on your application. Do not write 'see resume' on your application when completing the job duties section. If you answer the questions at the end of the application, please ensure your application reflects the knowledge, skills, abilities and experiences to support your answers (see job duties section of previous employment). Failure to answer the questions at the end of the application will not preclude your application from being considered but may result in your application not receiving full consideration of your knowledge, skills, and abilities. Applicants must be currently authorized to work in the United States on a full-time basis.
Job Open Date	09/13/2024
Job Close Date - Positions will be posted until 11:59 p.m. EST on this date; If no closing date is indicated, the position will be posted until filled and may close at any time after the recruitment has been completed.	09/24/2024
Open Until Filled	No
Quick Link for Direct Access to Posting	https://ecu.peopleadmin.com/postings/74817
Alternate option	If no applicants apply who meet the required competency level and training & experience requirements, then management may consider other applicants. Salary would be determined based on budget, UNC salary administration, and/or candidate qualifications.
AA/EOE	East Carolina University is an equal opportunity and affirmative action employer who is committed to workforce success and cultivating a culture of care, belonging and opportunity for our faculty, staff and learners and all stakeholders. All qualified applicants will receive consideration for employment without regard to their race/ethnicity, color, genetic information, national origin, religion, sex, sexual orientation, gender identity, age, disability, political affiliation, or veteran status. Individuals requesting accommodation under the Americans with Disabilities Act Amendments Act ( ADAAA) should contact the ADA Coordinator at (252) 737-1018 (Voice/ TTY) or ADA-Coordinator@ecu.edu.
Eligibility for Employment	Final candidates are subject to criminal & sex offender background checks. Some vacancies also require credit or motor vehicle checks. ECU participates in E-Verify. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. If highest degree earned is from an institution outside of the U.S. and its territories, final candidates are required to have their degree validated as equivalent to the degree conferred by a regionally accredited college or university in the U.S.
Department for People Operations, Success, and Opportunity	If you experience any problems accessing the system or have questions about the application process, please contact the Department for People Operations, Success, and Opportunity at (252) 328-9847 or toll free at 1-866-489-1740 or send an email to employment@ecu.edu. Our office is available to provide assistance Monday-Friday from 8:00-5:00 EST.