Job Description

Be inspired. Be valued. Belong. At Emory Healthcare

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1

• Student Loan Repayment Assistance & Reimbursement Programs

• Family-focused benefits

• Wellness incentives

• Ongoing mentorship, development, leadership programs

• And more

RESPONSIBILITIES:

• A Senior Manager of Hospital Billing oversees the entire hospital billing operation, ensuring accurate and timely submission of patient claims, managing a team of billing specialists, resolving complex billing issues, maintaining compliance with healthcare regulations, and implementing strategies to optimize revenue cycle management and maximize revenue collection for the hospital.
• Key responsibilities may include: 1. Team Leadership and Supervision: - Manage a team of billing specialists, including assigning tasks, performance evaluations, coaching, and staff development. - Monitor team productivity and identify areas for improvement to streamline billing processes. 2. Billing Operations Management: - Oversee all aspects of the hospital billing cycle, including patient registration, charge capture, coding, claim submission, accounts receivable follow-up, and payment posting. - Ensure accurate and timely billing by reviewing coding and charge entry for compliance with medical billing guidelines. - Monitor and address billing denials, appeals, and outstanding accounts receivable. 3. Compliance and Regulatory Adherence: - Stay updated on current healthcare billing regulations, including ICD-10, CPT codes, and payer policies. - Implement procedures to ensure compliance with HIPAA, Medicare, and other relevant regulations. - Conduct regular audits to identify and address potential billing compliance issues. 4.Revenue Cycle Optimization: - Analyze billing data to identify trends and opportunities for revenue improvement. - Develop and implement strategies to increase collection rates and reduce outstanding accounts receivable. - Collaborate with other departments like patient registration and clinical staff to improve data accuracy and streamline billing processes. 5. Financial Reporting and Analysis: - Generate comprehensive billing reports to track key performance indicators (KPIs) like denial rates, days sales outstanding (DSO), and revenue cycle metrics. - Analyze financial data to identify areas for cost reduction and revenue enhancement. 6.Payer Relations: - Build and maintain relationships with insurance payers to address billing issues and negotiate reimbursement rates. - Monitor and resolve billing disputes with payers. 7. Additional Duties as Assigned This role is a hybrid position splitting time between working remotely and working in the office.

Minimum Qualifications:

• Minimum of 7 years of related experience - Minimum of 3 years of supervisory or management experience - Bachelors Degree in healthcare or a related field - Deep understanding of medical billing codes (ICD-10, CPT) and healthcare billing regulations - Extensive experience in hospital billing operations, including revenue cycle management - Strong leadership and supervisory skills to manage a billing team - Excellent analytical and problem-solving abilities to identify and resolve billing issues - Proficiency in electronic health records (EHR) systems and billing software - Strong communication and interpersonal skills to collaborate with various stakeholders PHYSICAL REQUIREMENTS: Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste. chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting patient care/handling injuries, radiation, shift work, travel may be required, use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.