Employment Spot

Job Description

The Billing, EDI (Electronic Data Interchange) and Contract Administration Manager Senior manages the activities of Billing, EDI, Contract Teams and other staff.  Provides leadership, establishes goals, and oversees the execution of departmental goals. This position is accountable for overseeing the critical activities of the EDI billing and contract administration processes for Institutional, Managed Care, Medicare and Medicaid areas.   Ensures all personnel are fully trained in the established procedures for the department.  Actively participates, or leads intradepartmental teams to improve the order to cash cycle process.  Provides senior management with regular reports on department performance and makes recommendations for improvements where appropriate.

Job Requirements

Basic Qualifications:  

• Bachelors Degree in Accounting, Business, or related field.
• At least 6 years experience with EDI, Billing, and collections of Medicare and Medicaid including 2 years of supervisory experience
• Experience with MS Office applications including: Word, Excel, Access, PowerPoint, and OutLook

Other Qualifications:

�                                             Experience with EDI Healthcare with Institutional and Third Party Payers.

�                                             Knowledge of Managed Care, A/R and Collection regulations such as the Fair Debt Collections Practice Act (FDCPA) and other Federal, State and local policies regarding collection of debts from patients.

�                                             Knowledge of billing/coding terminology (ICD-9, CPT, Revenue Codes)

�                                             Demonstrated Credit, Billing and Accounts Receivable/Collections experience in the medical field,

�                                             Knowledge of Medicare/Medicaid, Managed Care Regulations, HIPPA EDI and business process analysis.

�                                             Knowledge of 1500 Forms, EOB (Explanation of Benefits) and denial codes

�                                             Experience with managed care appeals and denials management

�                                             Understanding of project management.

�                                             Demonstrated analytical & problem solving abilities as well accuracy and attention to detail.

�                                             Ability to management multiple projects simultaneously.

�                                             Demonstrated ability to identify and implement process improvements in an operational healthcare IT environment, with familiarity using structured methodologies like 6 sigma, lean, etc.

�                                             Ability to organize, manage and motivate professionals.

�                                             Demonstrated communication and  presentation skills.

�                                             Ability to work in a team environment, as well as independently.

�                                             Ability to maintain confidentiality and discretion in business relationships

Preferred Qualifications:      

�                                 Masters in Business Administration

• Experience with Durable Medical Equipment (DME)