Billing Manager

Job Description

Billing Manager

Care at Home Medical PC

Position Description

Overview

The Billing Manager reports to the CINQCARE’s Vice President of Quality and Risk Adjustment, with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members.

Care at Home is a Medical Practice that performs telehealth and in home annual comprehensive assessments, chronic condition management and remote patient monitoring. It will be developing the capacity to offer ongoing primary care services. Currently Care at Home bills for clinical services in 2 states (New York and Georgia). It will go live with billing for services in several other states in 2024. The programs are a key component of CINQCARE IPA and ACO’s Clinical, Quality and Risk Adjustment strategy.

Primary Responsibilities

The Billing Manager will have the following responsibilities:

Ensure timely submission of appropriately coded claims to multiple contracted payers.

Provide supervision and guidance to billing specialists.

Act as a liaison with payers, subcontractors, and the practice administration system vendor.

Allocate work to billing specialists, generate reports, and submit management summaries.

Process remittance advice, ensure claim resubmissions, and handle appeals.

Perform Coordination of Benefits tasks.

Conduct claim projects.

Perform other job-related duties as assigned.The Billing Manager will have the following General duties:

Leadership: The Billing Manager will manage all of the Care at Home day to day billing operations and will be a key component in the Care at Home Practice’s Administration.

Collaboration: The Billing Manager will collaborate with Care at Home subcontractors and vendors as needed.

Knowledge: The Billing Manager must have a strong working knowledge of and in-depth experience with medical practice billing.

Culture: The Billing Manager is accountable for creating a productive, collaborative, safe, and inclusive work environment as part of the larger Company.

Qualifications

The Billing Manager should have the following qualifications:

Education:

Associate degree in a related field required, bachelor’s degree preferred.

Medical Billing and Coding Certificate required.

Experience:

5 years medical billing experience at minimum required.

2 years supervisory or managerial experience at minimum required.

Entrepreneurial: CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQCARE is positioned to innovatively deliver on its mission and vision.

Communication: Excellent verbal, written communication, and presentation skills; ability to clearly articulate and present complex concept models in an accessible manner to CINQCARE’s team, partners, and other stakeholders.

Relationships: Ability to build and effectively manage relationships with business leaders and external constituents.

Culture: Good judgment, impeccable ethics, and a strong collaborator; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.Compensation: $78,000- $108,000 - Based on experience.

Location: Hybrid. May require occasional but infrequent travel into the Buffalo or New York City Office, or other CINQCARE or Care at Home locations.

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