Billing & Collections Manager

Summary: Oversee the daily operations of the Ins Billing & Collections Dept to ensure compliance with
billing policies and procedures. Monitor and analyze the performance of the collections team while
implementing measures to improve productivity and success rates.

Key Responsibilities
 Responsible for aspects of Insurance Category Billing and Collections for 911
and Non-Emergency Ambulance Service Provider such as verifying insurance
eligibility, billing patients, insurance companies & No-Fault & Worker’s Comp
claims.
 Responsible for claims submission electronically & via fax, and insurance
portals when required.
 Responsible for contacting insurance carriers and following up on outstanding
claims via online, telephone, portals and email.
 Identifying, completing, and resolving insurance denials in a timely manner to
expedite claims processing and payment.
 Knowledge of insurance EOB’s layout/ language and requirements for various
insurance carriers.
 Appealing insurance claims when required.
 Ensuring excellent customer service is provided when following up on
outstanding claims.
 Responsible for Appeals creation, submission and follow-ups as required.
 Liaison between senior management, employees, and clients to ensure proper
lines of communication are critical in addressing a myriad of problems and issues
requiring immediate attention and resolve.
 Review and evaluate Dept processes and procedures, determining appropriate
actions to be taken in accordance with company policies and billing practices.
 Responsible for assigning daily tasks to Ins teammates and ensuring daily target
goals are met on a consistent basis.
 Reviewing Ins Aging on a daily/ weekly basis to identify which tasks required
priority review to expedite processing/ payment.
 Ensure Insurance Category Dept meets/ exceeds established cash collection goals
on a consistent basis.
 Contact Patients/ Insurance carriers and take necessary action to ensure timely
payments.
 Understanding Customer Service relations to foster an environment of empathy
when contacting patients to ensure debt collections are secured in a timely
fashion.
 Provide General administrative and clerical support including but not limited to,
receiving, and sorting daily mail, maintaining medical records, faxing, copying,
scanning & stamping outgoing mail.

 Responsible for training and coaching team members on new and/or existing
procedures.
 Responsible for daily/ weekly & monthly reporting of following reports: Dept
Aging, Dept productivity, QA/QI’s, Ins Collections Daily Production such as Ins
Claim Status, Ins Denials, Appeals, ETC. Tasks Assignments/ Follow Ups, Dept
training refreshers & Internal QA/QI Dept Audits.
 Responsible for Ins Refunds account review processes and following refund
procedures with Finance Dept.
 Responsible for Evaluations/ Plan for Improvements (PFI) and any applicable
disciplinary action when required.
 Attending industry Webinars and preparing summary to ensure we are up to
date with industry & billing compliance standards.
 Responsible for completing Dept projects as assigned.
 Work closely with Dept Managers/ Supervisors to create improvement &
implement processes to ensure Dept goals and objectives are met on a
consistent basis.

Salary

Up to 60K/Year

POSITION QUALIFICATIONS
Education & Experience
 College degree, or Certification in Coding & Billing.
 Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR’s
and all forms of medical billing (direct, 3rd party, HMO’s, private pay, no-fault, worker’s comp, Medicare & Medicaid
 Excellent organizational skills and the ability to multi-task in a fast-paced environment
 Review and research data; use intuition and experience to complement data.
 Thorough knowledge of transport documentation (PCRs)
 Ability to follow up on outstanding Insurance/ Patient accounts.
 Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention
compliance.
 Excellent written and verbal communications skills required · Excellent documentation skills
(promptness, accuracy, thoroughness, and legibility).
 Credit & Collections Procedures, Payment Plan/ Settlements/ Collection Agency/ Ins Paid Pt
 Customer Service/ Debt Collection/ Client relations.
 Waystar/ Various Online Ins Portals.
Competencies:
 Working knowledge of EMS systems/private ambulance and medical transportation systems
preferred.
 Knowledge Microsoft Word, Microsoft Excel, PowerPoint, and Microsoft Windows.
 Familiarity with medical terminology
 Organizational and leadership abilities, detail oriented

Work Environment:
 Work is performed under normal working conditions, as in a standard office environment.
 Hybrid position, ability to work from home.
 Some Saturdays may be required.

Physical Requirements:
 High level of sitting/working at a desk
 Light physical effort (lift/carry up to 10 lbs.)
 Must be able to perform