Manager, Specialty Billing | Patient Financial Services

Scheduled Weekly Hours:

We are seeking a dedicated and experienced Manager of Specialty Billing to lead the daily operations of our specialty billing and payment posting department. This role is critical in ensuring accurate, timely billing and reimbursement processes, while maintaining compliance with all regulatory and payer requirements. The ideal candidate will bring strong leadership skills, a deep understanding of healthcare billing practices, and a passion for operational excellence in a fast-paced environment.

MINIMUM QUALIFICATIONS:

Education:

REQUIRED

Bachelor's degree in Healthcare Management, Business Administration, Accounting or related field.

Certification/Registration/Licensure:

N/A

Experience:

REQUIRED

Minimum of 5 years of experience in billing or accounts receivable, with at least 2 years in a managerial role.

POSITION SUMMARY:

The Manager of Specialty Billing is responsible for the daily operations of the specialty billing and payment posting. The Manager will manage complex billing process while ensuring accuracy, efficiency, and compliance with established polices. The Manager will embrace the development of technology and initiatives to drive improvements to ensure best practices to enhance departmental productivity and drive process automation. The Manager will collaborate closely with cross-functional teams to identify opportunities and implement effective solutions to streamline billing procedures, reduce denials and implement best practices within the billing cycle while providing leadership and accountability to organizational performance metrics and compliance of regulatory requirements.

ESSENTIAL JOB DUTIES/MAJOR RESPONSIBILITIES:
1. Provides supervisory review of billing, payment posting and refunds, staff for the Specialty Billing and Follow-up Lines of business for Emplify Health.
2. Will ensure that insurance payments are properly set up for EFT/ERA and posted within timely filing guidelines.
3. Works closely with Business Health Department on billing local businesses for services they are contracted for. This will include those local businesses institutional statements and monitoring payments.
4. Uses key performance indicators on dashboards and scorecards to monitor performance and direct resources as appropriate.
5. Analyze billing data to identify trends and discrepancies, providing recommendations for improvement.
6. Collaborate with other departments to resolve billing-related inquiries and customer disputes quickly.
7. Manage the team of billing specialists, providing guidance, training, and performance evaluations.
8. Prepare and present regular reports on billing performance metrics to senior management.
9. Ensure compliance with all financial regulations and company policies regarding billing and collections.
10. Leads systemwide initiatives and works in a collaborative relationship with other departments to improve billing processes.

Core for all Leaders

• Organizational Strategy and Implementation -- Recognizes market trends, judges the impact on their AOR, contributes to responsive strategic plans, develops AOR operational plans, articulates these plans, and ensures they are communicated to gain alignment and commitment of all AOR staff.

• Fiscal Management -- Effectively uses established processes to ensure accountability for effective operations and resource management.

• Human Resource Management -- Effectively uses established processes to: select, align, develop, motivate, manage, and retain a team of highly skilled employees.

• Excellence in Service and Quality-- Achieves seamless delivery of quality patient care, safety, excellence in patient experience, and customer service. Utilizes Continuous Quality Improvement principles and platform planning in decisions, improvements, and system design.

• Organizational Leadership -- Provides leadership and accomplishes objectives by ensuring the integration of processes and initiatives while modeling collaboration. Participates and supports in brand/service delivery teams as requested.

• Maintains accountability for implementation of requirements of regulatory agencies

• Serves as liaison to the community

• Duties and responsibilities as defined by specific department (if applicable)

PRACTICES AND PROMOTES BEHAVIOR CONSISTENT WITH THE MISSION, VISION AND VALUES:

Mission:

Together, we inspire your best life by relentlessly caring, learning and innovating.

Vision:

Leading with love, we courageously commit to a future of healthy people and thriving communities.

Values:

Belonging, Respect, Excellence, Accountability, Teamwork, Humility

Why Emplify?

• Tailored Benefits Package:We offer a comprehensive benefits package that varies based on your location. To learn more about the specific benefits available in your area, please inquire with the recruiter during the application process.

• Flexible work location:While this role offers some flexibility in work location, candidates must reside within a reasonable commuting distance of La Crosse or Green Bay, WI due to frequent on-site needs, approximately 3 days a week.

If you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267

We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values - belonging, respect, excellence, accountability, teamwork and humility - our pillars set our foundation and our future.

Equal Opportunity Employer