OrthoCincy
Business Office Manager
OrthoCincy, Fort Mitchell, Kentucky, United States, 41000
Job Type
Full-time
Description
Primary Functions:
Supervises business office personnel in the areas of insurance verification, compliance, scheduling of surgical procedures, and transcription of operative procedures in accordance with facility policies, procedures, philosophy, and objectives. Oversees billing/coding/accounts receivable work of the billing team. Maintains accounts payable records and supervises payment of supplies to include monitoring back orders. Responsible for payroll monitoring and reporting, daily backup of computer files, and security of backup tapes/disks. Coordinates activities with other departments and participates in obtaining and maintaining qualified personnel. Responsible for environmental control of area. Promotes a favorable image of the facility to physicians, patients, insurance companies, and the general public. May delegate duties as he or she deems necessary.
Employment Status
Exempt
Duties and Responsibilities:
1. Philosophy
a) Supports the facility's ideology, mission, goals, and objectives
b) Performs in accordance with the facility's policies and procedures
c) Follows the facility's standards for ethical business conduct
d) Conducts self in a professional manner, and as a positive role model and team member
e) Recognizes patients' rights and responsibilities and supports them in performance of job duties
f) Participates in facility committees, meetings, in-services, inventory and activities
2. Communication
a) Communicates effectively and professionally with patients, visitors, physicians, and coworkers
b) Interacts with others in a positive, respectful, and considerate manner
c) Maintains professional relationships with physicians and management
3. Supervisory duties
a) Directs supervision of business office personnel, including orientation, performance appraisal, and maintenance of business office personnel records
b) Ensures that business office duties are carried out according to facility policies and procedures
c) Ensures that business office duties are carried out efficiently and accurately
d) Works closely with Clinical Director to ensure the efficient, timely flow of overall operation
e) Overseeing revenue cycle management including coding, billing, collections, and denial management within the organization. Ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues.
f) Recommends revisions in business office policies and procedures to maintain compliance with federal and state rules and regulations
4. Compliance program
a) Contributes to the progress and development of the organization's adopted compliance program
b) Performs according to established compliance policies and procedures
c) Remains current on all federal and state guidelines regarding business office practices (e.g., fraud, abuse, and anti-kickback statutes)
5. Performance-improvement program
a) Contributes to the progress and development of the organization's adopted performance-improvement program
b) Performs according to established performance-improvement policies and procedures
6. Safety/Risk-management program
a) Adheres to safety policies and procedures in performing job duties and responsibilities
b) Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to safety officer or another designated person
7. Professional competence
a) Participates in continuing education and other learning experiences
b) Shares knowledge gained in continuing education with staff
c) Maintains membership in relevant professional organizations
d) Seeks new learning experiences by accepting challenging opportunities and responsibilities
e) Welcomes suggestions and recommendations
8.
Payroll
a) Organizes and maintains payroll and employee benefit records to maintain compliance with federal and state rules and regulations
b) Reviews timecards and payroll verification forms for accuracy and compliance with facility policies
c) Maintains records regarding vacation, sick leave, etc.
9. Financial practices
a) Uses facility resources appropriately and avoids wasteful practices
b) Reports wasteful practices
c) Analyzes work area and makes recommendations for potential cost-effective improvements
d) Ensures that financial transactions follow generally accepted accounting principles and facility policy
e) Works with Clinical Director to develop and maintain case cost analyses
f) Reviews pre-qualification of procedures by third-party payers
g) Serves as a positive liaison with insurance companies
h) Reviews facility fees for accuracy, uniformity, and continuity
10. Revenue Cycle
a) Oversee and manage entire revenue cycle including billing, coding, collections, and denial management
b) Manage relationships with external vendors for practice management software and clearinghouse vendor
c) Communicate professionally with various payers
d) Manage, develop, and mentor all revenue department staff, including billers and coders.
e) Oversee the admission process and manage the admissions team
f) Responsible for management and maintenance of billing and practice management software platform
g) Provide up to date education for clinical, billing, and coding staff on coding trends 8.
h) Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities & improvement strategies.
i) Reconcile all receivables and revenue reports and work closely with the management company in the development of the monthly financial statements.
j) Conduct analysis of Medicare/Medicaid/Third Party Payers
k) Review and resolve issues related to claim generation and rejected/denied billings
l) Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
m) Reviews, monitors, and evaluates third party reimbursement and researches variances
11. Scheduling
a) Oversees scheduling tasks to maintain efficient patient flow
b) Works closely with Clinical Director to ensure appropriate time allowances and special-equipment requests are communicated in a timely manner
c) Monitors physician block time and makes recommendations for effective utilization to Administrator
d) Oversees Scheduling Manager for compliance with facility policies and procedures
e) Serves as a positive liaison with physicians and their office personnel
12. Medical records
a) Oversees medical record maintenance to ensure timely dispensation of completed charts
b) Monitors medical record charts for accuracy, completeness, and compliance with federal and state rules and regulations
c) Maintains security and confidentiality of medical records
13. Credentialing
a) Oversees the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors.
Ensures computer scheduling module contains current licensure, malpractice insurance, and delineation of privilege information
Responsibility for Assets
1. Responsible for all office supplies and business office equipment
2. Responsible for petty cash
3. Responsible for scheduling book/computer module
4. Responsible for medical records
5. Responsible for human resource and business office reference materials
6. Responsible for financial and payroll records
Requirements
Qualifications
Cooperative work attitude toward coworkers, management, patients, visitors, and physicians Ability to promote favorable facility image with physicians, patients, insurance companies, and general public Ability to make decisions and solve problems Requirements
Required
High school diploma or GED certificate Training or courses in business office activities Two years of medical facility or medical business office experience Strong ethical and moral character references Preferred
Supervisory experience ASC experience Strong accounting background in a medically related environment Basic knowledge of accounting procedures Strong knowledge of computers (e.g., word processing, spreadsheets, automated computer billing systems) Strong managed-care expertise with Medicare, Medicaid, and/or third-party payers Good oral and written communication skills Basic knowledge of medical terminology Basic knowledge of anatomy Job Quality Requirements
Accuracy Attention to detail Timeliness Organization Little supervision needed to accomplish tasks Dependability
Attendance Punctuality Ability to follow instructions Ability to meet deadlines Physical/Mental Requirements
Ability to sit/stand for long periods; ability to walk Visual and auditory acuity for frequent use of computer and telephone, and occasional use of other office equipment Working Conditions (Environmental)
Well lit and ventilated, with non-hazardous and hazardous equipment Category III: exposure to bloodborne pathogens and may encounter chemical hazards Reports to:
Clinical Director
Supervises
Staff directly related to business office
Contacts
Patients Patients' family/significant others Physicians and physician office personnel Insurance company personnel Facility personnel Vendors Facility Administration Committees
Full-time
Description
Primary Functions:
Supervises business office personnel in the areas of insurance verification, compliance, scheduling of surgical procedures, and transcription of operative procedures in accordance with facility policies, procedures, philosophy, and objectives. Oversees billing/coding/accounts receivable work of the billing team. Maintains accounts payable records and supervises payment of supplies to include monitoring back orders. Responsible for payroll monitoring and reporting, daily backup of computer files, and security of backup tapes/disks. Coordinates activities with other departments and participates in obtaining and maintaining qualified personnel. Responsible for environmental control of area. Promotes a favorable image of the facility to physicians, patients, insurance companies, and the general public. May delegate duties as he or she deems necessary.
Employment Status
Exempt
Duties and Responsibilities:
1. Philosophy
a) Supports the facility's ideology, mission, goals, and objectives
b) Performs in accordance with the facility's policies and procedures
c) Follows the facility's standards for ethical business conduct
d) Conducts self in a professional manner, and as a positive role model and team member
e) Recognizes patients' rights and responsibilities and supports them in performance of job duties
f) Participates in facility committees, meetings, in-services, inventory and activities
2. Communication
a) Communicates effectively and professionally with patients, visitors, physicians, and coworkers
b) Interacts with others in a positive, respectful, and considerate manner
c) Maintains professional relationships with physicians and management
3. Supervisory duties
a) Directs supervision of business office personnel, including orientation, performance appraisal, and maintenance of business office personnel records
b) Ensures that business office duties are carried out according to facility policies and procedures
c) Ensures that business office duties are carried out efficiently and accurately
d) Works closely with Clinical Director to ensure the efficient, timely flow of overall operation
e) Overseeing revenue cycle management including coding, billing, collections, and denial management within the organization. Ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues.
f) Recommends revisions in business office policies and procedures to maintain compliance with federal and state rules and regulations
4. Compliance program
a) Contributes to the progress and development of the organization's adopted compliance program
b) Performs according to established compliance policies and procedures
c) Remains current on all federal and state guidelines regarding business office practices (e.g., fraud, abuse, and anti-kickback statutes)
5. Performance-improvement program
a) Contributes to the progress and development of the organization's adopted performance-improvement program
b) Performs according to established performance-improvement policies and procedures
6. Safety/Risk-management program
a) Adheres to safety policies and procedures in performing job duties and responsibilities
b) Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to safety officer or another designated person
7. Professional competence
a) Participates in continuing education and other learning experiences
b) Shares knowledge gained in continuing education with staff
c) Maintains membership in relevant professional organizations
d) Seeks new learning experiences by accepting challenging opportunities and responsibilities
e) Welcomes suggestions and recommendations
8.
Payroll
a) Organizes and maintains payroll and employee benefit records to maintain compliance with federal and state rules and regulations
b) Reviews timecards and payroll verification forms for accuracy and compliance with facility policies
c) Maintains records regarding vacation, sick leave, etc.
9. Financial practices
a) Uses facility resources appropriately and avoids wasteful practices
b) Reports wasteful practices
c) Analyzes work area and makes recommendations for potential cost-effective improvements
d) Ensures that financial transactions follow generally accepted accounting principles and facility policy
e) Works with Clinical Director to develop and maintain case cost analyses
f) Reviews pre-qualification of procedures by third-party payers
g) Serves as a positive liaison with insurance companies
h) Reviews facility fees for accuracy, uniformity, and continuity
10. Revenue Cycle
a) Oversee and manage entire revenue cycle including billing, coding, collections, and denial management
b) Manage relationships with external vendors for practice management software and clearinghouse vendor
c) Communicate professionally with various payers
d) Manage, develop, and mentor all revenue department staff, including billers and coders.
e) Oversee the admission process and manage the admissions team
f) Responsible for management and maintenance of billing and practice management software platform
g) Provide up to date education for clinical, billing, and coding staff on coding trends 8.
h) Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities & improvement strategies.
i) Reconcile all receivables and revenue reports and work closely with the management company in the development of the monthly financial statements.
j) Conduct analysis of Medicare/Medicaid/Third Party Payers
k) Review and resolve issues related to claim generation and rejected/denied billings
l) Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
m) Reviews, monitors, and evaluates third party reimbursement and researches variances
11. Scheduling
a) Oversees scheduling tasks to maintain efficient patient flow
b) Works closely with Clinical Director to ensure appropriate time allowances and special-equipment requests are communicated in a timely manner
c) Monitors physician block time and makes recommendations for effective utilization to Administrator
d) Oversees Scheduling Manager for compliance with facility policies and procedures
e) Serves as a positive liaison with physicians and their office personnel
12. Medical records
a) Oversees medical record maintenance to ensure timely dispensation of completed charts
b) Monitors medical record charts for accuracy, completeness, and compliance with federal and state rules and regulations
c) Maintains security and confidentiality of medical records
13. Credentialing
a) Oversees the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors.
Ensures computer scheduling module contains current licensure, malpractice insurance, and delineation of privilege information
Responsibility for Assets
1. Responsible for all office supplies and business office equipment
2. Responsible for petty cash
3. Responsible for scheduling book/computer module
4. Responsible for medical records
5. Responsible for human resource and business office reference materials
6. Responsible for financial and payroll records
Requirements
Qualifications
Cooperative work attitude toward coworkers, management, patients, visitors, and physicians Ability to promote favorable facility image with physicians, patients, insurance companies, and general public Ability to make decisions and solve problems Requirements
Required
High school diploma or GED certificate Training or courses in business office activities Two years of medical facility or medical business office experience Strong ethical and moral character references Preferred
Supervisory experience ASC experience Strong accounting background in a medically related environment Basic knowledge of accounting procedures Strong knowledge of computers (e.g., word processing, spreadsheets, automated computer billing systems) Strong managed-care expertise with Medicare, Medicaid, and/or third-party payers Good oral and written communication skills Basic knowledge of medical terminology Basic knowledge of anatomy Job Quality Requirements
Accuracy Attention to detail Timeliness Organization Little supervision needed to accomplish tasks Dependability
Attendance Punctuality Ability to follow instructions Ability to meet deadlines Physical/Mental Requirements
Ability to sit/stand for long periods; ability to walk Visual and auditory acuity for frequent use of computer and telephone, and occasional use of other office equipment Working Conditions (Environmental)
Well lit and ventilated, with non-hazardous and hazardous equipment Category III: exposure to bloodborne pathogens and may encounter chemical hazards Reports to:
Clinical Director
Supervises
Staff directly related to business office
Contacts
Patients Patients' family/significant others Physicians and physician office personnel Insurance company personnel Facility personnel Vendors Facility Administration Committees