Post-Claim Billing Manager

Description

CPIhealth is an interventional pain practice with a multidisciplinary team dedicated to providing empathetic, compassionate, and comprehensive care to individuals experiencing chronic pain. With state-of-the-art facilities, advanced technology, and a collaborative environment, we offer a platform for healthcare providers to excel in their specialties while making a profound difference in the lives of those we serve.

As you consider your next career move, we invite you to join us in redefining pain management through innovation, expertise, and a commitment to improving patient outcomes. Together, we can shape the future of healthcare and positively impact countless lives.

The Post-Claim Billing Manager is responsible for overseeing and managing all activities that occur after a claim is submitted and posted in the Revenue Cycle Management (RCM) process. This role includes the management of insurance and patient accounts receivable (AR), follow-up on unpaid claims, and resolving patient inquiries regarding their accounts.

The Post-Claim Billing Manager ensures timely collections, accurate account reconciliation, and effective communication with patients and insurance companies to minimize outstanding balances and improve cash flow.

Responsibilities

Insurance AR Management:

• Oversee the insurance follow-up process, ensuring claims are paid in a timely manner.
• Monitor and analyze aging reports to identify overdue claims and ensure follow-up actions are taken.
• Resolve complex claim denials, underpayments, and discrepancies with insurance companies through follow-ups and appeals.
• Work closely with the Denials Management team to reduce denial rates and ensure proper payment.
  
  

Patient AR Management

• Oversee the patient billing process, ensuring that accurate statements are generated and sent to patients.
• Implement strategies to reduce patient outstanding balances and improve collection rates.
• Manage patient payment plans and work with patients to resolve account issues, including financial counseling if needed.
• Ensure patient AR aging is monitored, and follow-up actions are timely and effective.
  
  

Patient Communication

• Manage a team responsible for handling inbound and outbound patient calls related to billing inquiries, account balances, and payment options.
• Ensure that patient phone calls are handled professionally, with a focus on customer service and effective issue resolution.
• Develop and implement protocols for resolving patient complaints or escalations related to billing or payment issues.
  
  

Team Management

• Lead, train, and mentor the AR and patient billing team to ensure high performance and adherence to policies.
• Set performance metrics for the team related to AR follow-up, collections, and patient satisfaction.
• Reporting & Analysis:
• Provide regular reporting on AR performance, collection rates, and patient call resolution to senior management.
• Analyze trends in unpaid claims, denials, and patient payments to recommend process improvements.
  
  

Compliance

• Ensure all post-claim activities comply with federal, state, and payer-specific regulations.
• Keep updated with changes in insurance policies, regulations, and patient billing practices to ensure the team follows the best practices.
• Performs other duties as assigned to support the mission, values, and strategies of CPIhealth.
  
  

This job description should not be interpreted as an exhaustive list of responsibilities or as an employment agreement between the employer and the employee. The above statements are intended to describe the general nature and level of work performed by employees assigned to this classification and are subject to change as the employer's needs and the job change.

Requirements

• Bachelor’s degree in business administration, healthcare administration, or related field (preferred).
• 5+ years of experience in medical billing and RCM, with a focus on AR management.
• Strong knowledge of insurance claim processes, billing regulations, and payer requirements.
• Excellent leadership and communication skills.
• Ability to manage and analyze large datasets related to AR and patient accounts.
• Proficiency with MS Office and medical billing software (e.g., ECW, Epic, Cerner, Athenahealth) and financial reporting tools.
• Experience in pain management or Ambulatory Surgery Centers is ideal.
  
  

Dress Code: Business Casual

Salary: $65K and up | Depending on Experience

Schedule: Monday to Friday

Location: Shoal Creek Blvd, Austin, TX 78757

Comprehensive Benefits Plan Including

• Medical, Dental, Vision insurance
• Paid Time Off (accrued)
• Flexible Spending Account for Health & Dependent Care
• Basic Life, Accidental Life, Supplemental Life Insurance
• Short Term & Long-Term Disability
• 401(k) with matching