Orthopaedic Associates of Michigan

Hours: Typical schedule is Monday-Friday, 8:00AM-5:00PM, but times can vary depending on certain circumstances.

Work Environment: Remote, but will require some on-site days as needed.

About Us: Orthopaedic Associates of Michigan (OAM) is proud to be West Michigan’s most established orthopaedic practice. Our physicians and team members provide exceptional, individualized care for patients of all ages. As the most comprehensive independent provider of musculoskeletal care in the region, we provide total care from diagnosis, to treatment, to rehabilitation. As a patient at OAM, you will have access to our Specialized Surgeons, Physical and Occupational Therapists, Pool Therapy, onsite and cost effective MRI and X-ray services, and orthopaedic bracing, as well as our Bone Health Clinic, OAM Now Urgent Orthopaedic Care Clinic, and Surgery Center at MidTowne – all of which are committed to optimizing your outcome. Our teams work together to maximize and adjust your treatment quickly and easily, resulting in a smoother, faster recovery for you. From your neck to your toes, and from traumatic injuries to chronic conditions, you’ll receive compassionate care that will get you back to living. Your goal is our goal – we will restore your health so you are functioning as fully as possible in the activities you love at home, work, and play.

Position Summary: As the Billing Manager at OAM, you will be responsible for overseeing all functions within the Central Billing Office. You will provide supervision and guidance to the Accounts Receivable team and ensure that all processes and procedures laid out by OAM’s Revenue Cycle department are followed throughout the billing process. Understanding how to manage and execute the daily activities of insurance billing (i.e. claims status and rejections, financial counseling, payment/adjustment posting and reconciliation, patient balance collections, patient billing statements, credit balance resolution, refund processing, etc.) will be key in guaranteeing that patients receive the best customer service and care possible from point of service through to the resolution of their accounts.

Essential Responsibilities:

Patient Account and Claims Management:

-Review current status of patient accounts to identify and resolve billing and processing problems in a timely manner.

-Oversee initial correspondence for all patient disputes pertaining to financial matters.

-Establish and implement a system for timely collection of accounts receivable.

-Review credit balance reports in order to ensure statements of account balances are correct, overpayments are identified, and refunds are properly processed.

-Ensure accurate postings of payments and adjustments are made in a timely manner in order to reflect on the end of day posting reconciliation.

-Maintain credit balances at or below the established standard.

-Review all Financial Assistance applications to determine eligibility.

-Establish and maintain positive working relationships with third-party intermediaries (i.e. PPO’s, HMO’s, Medicare, etc.)

-Maintain contact with various OAM departments (i.e. registration, pre-authorization, coding, scheduling, etc.) in order to obtain information needed to process claims in a timely manner.

-Control and monitor the reconciliation of claims generation by ensuring all suspended, rejected, or pending claims are corrected and re-transmitted.

-Reconcile claims acknowledgement reports provided by payers with claims generation reports.

-Track and resolve claims in compliance with written procedures.

-Monitor status of unbilled claims to ensure accurate follow-up activity is conducted.

-Ensure secondary claim submission is conducted within 48 hours of primary payment posting.

-Ensure all hard copy claims are generated and mailed in a timely manner.

-Conduct random audits and prepare reports that reflect activities, issues, and resolutions as they pertain to the accuracy, validity, and timeliness of:

--Billing to patient accounts and third-party payers.

--Posting of payments, credits, adjustments, etc.

--Filing of denied, rejected, and unbilled claims and appeals.

--Obtaining documentation that meets compliance standards on patient accounts.

--Other metrics as requested or needed.

-Provide the Revenue Cycle Director and upper management with reporting results, issues, and solutions in a timely manner.

-Stay up to date on current government, insurance, and third-party payer regulations, requirements, guidelines, policies, etc., and ensure that the Billing department is in compliance with them.

-Establish and maintain appropriate documentation and statistical records that allow for complete accountability of patient account transactions as required by law and/or fiscal intermediaries.

-Ensure personal and team adherence to OAM policies and procedures (i.e. patient confidentiality, HIPAA, etc., employee records, company information that is not publicly shared, etc.)

-Manage payer website access for all staff members within the practice.

Leadership and Personnel Management:

-Exemplify excellent customer service by showing interest, concern, appreciation, respect, and empathy for all patients, patient family members, vendors, physicians, and employees.

-Model professionalism, commitment, collaboration, and a positive attitude at all times.

-Demonstrate not only the ability, but also the willingness to make decisions based on sound judgement. -Seek out and participate in professional growth opportunities.

-Create a positive teamwork environment where employees feel motivated, supported, and recognized.

-Ensures that effective relationships are established with physicians, co-workers and all other Departments of OAM.

-Work closely with other department leaders to ensure excellent communication regarding all areas of the revenue cycle.

-Recommend process and policy improvements as needed (including writing Standard Operating Procedures and policy documents from scratch) and communicate updates to the team.

-Maintain current, detailed knowledge of applicable technology and make recommendations to leaders on how to implement up-to-date technology within the department.

-Participate as an active member in team initiatives and attend all meetings as requested/required. -Assess and hire for staffing needs within the department.

-Develop training programs and provide updated education on job duties, compliance standards, professional associations, etc. to the team.

-Conduct training, performance evaluations, coaching, meetings, etc. for staff.

-Monitor productivity of staff and ensure that assignments and hours are adjusted based on workload.

-Ensure all staff demonstrate excellent customer service and maintain productivity in accordance with established metrics.

-Monitor productivity and error reports, time/attendance records, PTO requests, payroll tracking, etc. of direct reports.

-Maintain a safe work environment that adheres to safety standards established by departmental and OAM policy.

-Perform all other duties or special projects not specifically mentioned above as requested. Required & Preferred Qualifications

Education, Training, and Experience:

-Required: --5+ years of medical billing experience --2+ years of supervisory experience in a billing office with 10+ employees. --Experience working in EMR/EHR systems and third-party payment portals.

-Preferred: --Bachelor’s degree in business or related field. --Experience working in NextGen. --Experience billing in orthopaedics. *An equivalent combination of education and experience may be considered.*

Specific Skills, Knowledge, and Abilities:

-Excellent verbal and written communication skills.

-Ability to easily and efficiently pull reports from various computer applications.

-Integral knowledge of accounts receivable and point-of-service patient collections.

-Tech savviness:

--Intermediate Excel skill level (i.e. managing and formatting spreadsheets, inputting formulas, utilizing basic functions, creating pivot tables, etc.) with the ability to easily learn advanced skills as needed.

--Intermediate level keyboarding and 10 key.

--Knowledge of practice management systems.

-Proven success managing a successful team.

-Proven success of expense reduction.

-Proven managerial success in analyzing accounts receivable reports.

-Knowledge of CPT/ICD-10 coding.

-Knowledge of third-party payer operating procedures, regulations, and billing requirements.

-Familiarity with the Health Insurance Portability and Accountability Act.

-Knowledge of government reimbursement programs.

-Ability to multitask and remain detail-oriented when working in fast-paced, high-pressure environment.

Motor, Sensory, and Physical Requirements:

-Ability to sit for long periods of time.

-Manual dexterity required to operate modern office equipment.

-Occasional bending, stooping, lifting (of up to 50 lbs), and reaching may be required.

-Normal or correctable range of hearing and eyesight.

Apply by visiting: Careers | Orthopaedic Associates of Michigan (oamichigan.com)

Or Email: logan.karasinski@oamichigan.com