This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Reporting to and working with the Director of Billing, the Billing Manager role is responsible for the oversight of all functions related to the billing operations of 50-60 clients. This includes managing a team of 12-15 employees ensuring the accurate capture of all revenue, clean claims submissions both electronically or via mail, the management of Clearing House rejections, creating and administering ongoing training to staff, and upholding the integrity of the organization. Must have Orthopedic/ Pain Management/ Ambulatory Surgery Center billing experience and be COC, CPC, or CASCC Certified. - Implementation and oversight of best practices relating to quality assurance outcomes for both internal processes and external vendor processes. - Oversight for billing specifications for all client payers in assigned region, which includes communication of specifications to staff, training on requirements, and provision of tools and resources. - Routine audits of claim submissions sent electronically and via paper with the appropriate attachments. - Assist when needed for charge entry, pulling operative notes, claims transmission and working claim rejections. - Assist in developing new tools to streamline processes. - Coordinate coverage when needed to keep region current. - Manage a team of 12-15 employees. - Provides feedback and proposes changes or enhancements to billing policies and procedures. - Provide ongoing training to improve overall performance of Billing Specialist. - Performs other job-related duties as assigned. Qualifications - Orthopedic/ Pain Management/ Ambulatory Surgery Center billing experience. - COC, CPC, or CASCC Certified. Company Description

• Evaluates medical records and provides clinical and surgical abstraction for complex surgical services • Accurately codes diagnostic and procedural information • Consults with medical providers for clarifications • Abstracts clinical diagnoses and procedure codes • Ensures compliance with coding rules and regulations • Compiles daily and monthly reports

• Review the complete electronic and scanned medical records of discharged patients. Assigns ICD-10-CM diagnosis and ICD-10-PCS procedure codes from documentation in the medical record. • Abstracts coded data and patient information into the coding abstracting system in use by BILH (examples of information include attending physician, surgeon, surgery dates, disposition, discharge date, and infant birth weight). • Applies ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, AHA Coding Clinic Advice when coding inpatient records, and facility-specific guidelines. • Sequences the assigned codes using 3M software, and exercises all principles of assigning and sequencing ICD-10-CM and ICD-10-PCS codes for comprehensive coding and appropriate DRG assignment. • Participates in training programs, including educational sessions for ICD-10-CM and ICD-10-PCS coding guidelines and updates. • Follows hospital-specific guidelines to identify and facilitate prompt resolution of documentation, abstracting and/or other account problems.

• Codes and abstracts diseases, procedures from the medical record according to ICD-CM and CPT classification systems • Participates in quality improvement activities by identifying specific cases and pertinent data as requested • Completes and monitors follow up activities, complete documentation, MD Query responses, claim and DNB edits, daily • Communicates with physicians concerning incomplete documentation and clarification of diagnoses/procedures utilizing appropriate facility query process • Validates coding to assure proper APC assignment