Manager - Billing Operations

Position Summary

Caris is seeking a full time Manager for our Billing Operations to oversee the day-to-day operations for a defined payor group.  This position will be responsible for managing billing processes with a focus on resolving front-end rejections, submitting medical necessity appeals, and responding to medical records requests from payors.  This position plays a critical role in maximizing revenue by ensuring efficiency in billing procedures and compliance with regulatory standards. 

Job Responsibilities

• Manage a team with focused responsibilities resolving front-end rejection, submitting medical necessity appeals, and responding to medical records requests from regional payors. 

• Oversee daily and weekly production and quality to ensure the team is exceeding expectations.

• Provide accounts receivable management by monitoring and following up on unpaid claims, denied claims, and billing discrepancies.

• Prepare regular operational reports to track department performance, identify trends, and recommend improvements. 

• Hire, train and develop team. Provides direction to and development of associates through daily coaching, the administration of Performance Management, and the creation and implementation of development plans.

• Provide expert technical guidance to functional and cross-functional efforts that independently address complex challenges to facilitate decision-making.

• Draft and revise Standard Operating Procedures and training materials as required.

• Assist as needed to perform other related duties and special projects as required.

• Accept other duties as assigned.

Required Qualifications

• High School degree or equivalent required

• 5+ years of experience in medical billing with at least 3 years’ experience in a supervisory or management role.

• Demonstrated leadership and interpersonal skills. Willingness to lead by example.

• Understands HIPAA and importance of privacy of patient data.

• Experience working with Medicare Advantage plans is a plus

• Experience with Xifin is a plus

• Understanding of CPT, ICD-10, and HCPCS coding, payor regulations, and revenue cycle management

• Ability to motivate and engage staff in meeting/exceeding performance goals.

• Demonstrated track record in managing change.

• Demonstrated ability to lead and motivate a team in a fast-paced environment.   

• Ability to think creatively and initiate new ideas or solutions to business issues.

• Strong knowledge of Microsoft Office Suite, specifically Access, Word, Excel, Outlook, Accounting Software, and general working knowledge of Internet for business use. Demonstrated ability to learn new software.

Preferred Qualifications

• Bachelor’s preferred.

• Experience in a laboratory role is preferred.

• Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that lead to the delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.

• Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results.

• Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.

• Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

Physical Demands

• Must possess ability to sit and/or stand for long periods of time.

• Must possess ability to perform repetitive motion.

• Ability to lift up to 15 pounds.

• Majority of work is performed in a desk/cubicle environment.

Required Training

• All job specific, safety, and compliance training are assigned based on the job functions associated with this employee.

Other

• Willingness to work shift work and overtime is required.

• Job may require occasional weekends, evenings, and/or holidays.

Conditions of Employment:  Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check ( applicable for certain positions) and reference verification.

This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.