Department: Business Office
Hours: Fulltime
Description:
Position Overview: The Billing and Collections Manager is responsible for overseeing the day-to-day operations of Floyd County Medical Center’s Billing and Collections Department (Business Office). This exempt leadership position ensures departmental activities comply with hospital standards, payer requirements, and federal and state regulatory guidelines while supporting organizational revenue cycle goals.
This role requires extensive knowledge of healthcare billing, reimbursement methodologies, and collections processes. The Billing and Collections Manager supervises Medical Billing Specialists, Patient Financial Advocates, and Payment Posters, and collaborates closely with Patient Access, Health Information Management (HIM), Coding, Revenue Cycle leadership, and external service providers to optimize reimbursement and maintain compliance.
Essential Duties and Responsibilities:
- Department Operations & Revenue Oversight
- Oversees daily operations of hospital and clinic billing and collections functions.
- Ensures timely and accurate claim submission, follow-up, collections, and payment posting activities.
- Monitors Accounts Receivable (A/R) days and other key performance indicators to optimize cash flow and reimbursement.
- Assists staff in resolving complex payment, claim, billing issues, and patient complaints.
- Coordinates Skilled Nursing Facility (SNF) billing with area nursing homes.
- Implements and maintains electronic claim billing software and related systems.
- Payer Relations & Interdepartmental Collaboration
- Maintains current knowledge of payer updates and communicates changes to appropriate departments.
- Collaborates closely with Patient Access regarding insurance eligibility, payer website updates, prior authorizations, and medical necessity requirements.
- Works in coordination with the HIM team regarding claim processing issues.
- Partners with the Coding Manager and coding team regarding modifiers, authorizations, observation, and inpatient billing requirements to ensure proper reimbursement.
- Collections & Regulatory Oversight
- Oversees collection agency and bad debt processing, including monthly review and approval of accounts turned over to collections.
- Oversees bankruptcy processing and facilitates payment arrangements for self-pay accounts.
- Oversees probate filings and collaborates with attorneys on liability cases, court actions, and settlements.
- State Health Insurance Information Program (SHIIP) Coordination
- Serves as the SHIIP Facilitator and collaborates closely with the Director of Revenue Cycle on all SHIIP-related activities and initiatives.
- Oversees SHIIP volunteer recruitment, training, scheduling, and Welcome to Medicare seminars.
- Manages and coordinates the Medicare Open Enrollment process (October–December) with the SHIIP volunteers.
- Maintains and reports required SHIIP statistical documentation.
- Financial Reporting & Compliance Support
- Provides required data and reporting for the annual Cost Report, financial audits, and other regulatory reporting.
- Ensures compliance with Medicare, Medicaid, commercial payer requirements, and applicable state and federal regulations.
- Leadership & Staff Development
- Supervises, mentors, and evaluates Billing and Collections team members.
- Promotes accountability, customer service excellence, and continuous improvement within the department.
- Ensures staff are properly trained and informed of payer changes and billing regulations.
- Additional Responsibilities
- Assists in inventory and ordering of supplies and equipment.
- Assists in maintenance of safe, clean work environment.
- Assists with the general operation of the Billing and Collection Department (Business Office)
- Assumes other duties and responsibilities that are related and appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.
Minimum Education and/or Experience Required:
- Bachelor’s degree preferred; equivalent on-the-job experience will be considered.
- Previous experience in a healthcare billing or revenue cycle setting required.
- Demonstrated knowledge of Medicare, Medicaid, Blue Cross Blue Shield, and other commercial payer billing requirements.
- Experience with Motor Vehicle, Workers’ Compensation, Hospice, and liability billing preferred.
Additional Qualifications:
- Strong computer skills.
- Excellent oral and written communication skills required.
- Demonstrated customer service and interpersonal skills to communicate effectively with patients, staff, providers, and payers.
- Ability to resolve issues professionally, provide guidance, and maintain positive relationships with internal and external stakeholders.
- Strong leadership and coaching skills, supporting team members while ensuring high-quality service and compliance with billing standards.
- Self-motivated.
- Must be able to read, write, comprehend, and verbally communicate in English fluently.
- Integrity and ability to work independently. Initiative to take on tasks without being told.
- Strong attention to detail.
- Adaptive to change, embraces change with optimism.
- Ability to problem solve, critically think.
- Ability to prioritize assignments and manage time efficiently.
- Ability to operate technologies and equipment associated with this position.
- Must have a service mindset and a commitment to continuous learning.
- Ability to work outside of regularly scheduled hours if needed.
- Mandatory Reporter.
Licensure/Certification Required:
Certified Revenue Cycle Representative (CRCR) preferred.
Physical/Cognitive Requirements:
- Sit: Constant
- Stand: Occasionally
- Walk: Occasionally
- Lift:
- 10 pounds Frequent
- 25 pounds: Occasionally
- 50 pounds*: Never
- 75 pounds*: Never
- Greater than 100 pounds*: Never
- Carry:
- 10 pounds: Frequent
- 25 pounds: Occasionally
- 50 pounds*: Never
- 75 pounds*: Never
- Greater than 100 pounds*: Never
- Push/Pull:
- 10 pounds: Frequent
- 25 pounds: Occasionally
- 50 pounds*: Never
- 75 pounds*: Never
- Greater than 100 pounds*: Never
- Squat/Kneel/Crouch: Occasionally
- Climb: Never
- Balance: Never
- Twist: Frequent
- Bend/Stoop: Occasionally
- Crawl: Never
- Grasp/Grip: Frequent
- Talk: Frequent
- Hear: Frequent
- See: Constant
- Anything greater than 50 pounds- assist of two or more, or mechanical lift are required.
Environmental Factors:
- May be exposed to communicable diseases due to working in a health care environment.
- Works in a well-illuminated climate-controlled environment.
- Work environment is comfortable, with minimal exposure to physical hazards.
- Moderate noise level when machines/equipment in use but typically quiet environment.
Organizational Relationships:
Reports to: Revenue Cycle Director
Employees supervised: Medical Billing Specialists, Patient Financial Advocates, Payment Posters
