Medical Billing Manager

Billing ManagerHere at Clinical Care Medical Centers, we are in need of a Billing Manager with in-depth knowledge of Procedural Coding, identifying appropriate ICD-10 coding based on CMS/HCC categories, CPT, HCPS CMS 1500 FORM, HEDIS, MRA, Super Bill, Electronic Claims Submission and Clearing House Operations, EOB and payments, denials and appeals, Billing, Collections and Appeals processes and Medicare and Medicare Advantage billing methodology and processes.Qualifications/Education:Certified Professional Coder CertificationBi-lingual English/Spanish preferred; must be able to read, write and speak English.3+ years of experience in Managing a Medical Billing Department.Moderate computer knowledge: MS Word and MS Excel, internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send e-faxes and email.Strong people skills; independent decision making and customer service oriented.Strong Organizational SkillsCredentialing experience, preferred.Essential Duties and Responsibilities:Review medical records to identify if appropriate ICD-10 coding based on CMS/HCC categories is correct for billing purposesCreate and submit insurance claims to different insurance companiesProcess patients' billing, statements, reimbursement claims, post transaction and dataProper documentation to different level of appeals based on insurance denialsCommunicating with insurance compliance for claim(s) payment/ rejectionsSubmission of Doctor's application(s) for credentialing to insurance company(ies) as well as hospitalsCollects patient payments with by mail or via telephone and ensure payments are properly recorded and processedAssist Practice Administrator in updating practice or Doctor's license(s) including but not limited to county, city and CLIA as well as distributing HEDIS/MRA reports to multiple providersAssist in the balancing of copays and Insurance payments for other service facilitiesTransmit Financial Report to AccountantReview A/R regularly and take the necessary collection actionEnsure HEDIS Claims Tracking and ReportingPosting payments via ERA and manual posting of all Medicare, Medicaid and Third-Party PayersReview accounts for possible assignment and make recommendations to the practice administratorPerforms other duties as assigned.At Clinical Care Medical Centers, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by applicable law. Clinical Care Medical Centers believes that diversity and inclusion among our employees is critical to our success as a company. We support an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.