Development and Integration Manager
JOB SUMMARY: Responsible for maintaining pricing and rates in billing software and working with Providers to assure claim submission and electronic file receipt. The position is also responsible for training and reviewing new products for Billing Department, recording and follow-up on ADR/Appeals.
ESSENTIAL FUCNTIONS:
1. Develops and maintains billing software
2. Participates in pilot programs with billing software implementation personnel to enhance performance of software applications relating to the billing and Business Office functions.
3. Studies and works with outside vendors to be able to keep up with industry technology as it relates to billing and Business Office processes.
4. Responsible for development of training programs to educate Center B.O.M.’s and Home Office billing staff along with Regional B.O.M.’s and Home Office Training personnel.
5. Responsible for ADR/Appeal adjustments and write offs executed in accordance with the Business Office P & P.
6. Plans and attends regular meetings with the Director of Accounts Receivable and other corporate billing staff.
7. Analysis of system set ups at the centers and reports findings to appropriate personnel for re-training purposes.
8. Quality improvement of billing procedures
9. Updates Policies and Procedures related to billing and set up as needed
10. Actively participates in Service Excellence
11. Attends Medicare, Medicaid, and other Insurances training sessions via teleconference or in person to keep informed of current billing changes and policies.
12. Works with Payers on electronic billing and remittance advice set up to be able to submit claims electronically and receive remittance advice electronically.
13. Works with Clinical staff as needed for implementation of processes that integrate with the clinical applications.
14. Assist with month end revenue proofs/processing at the Home Office
15. Tracks and Manages ADR Requests
16. Supervises Intake staff
17. May travel to Centers as needed.
18. Promote and demonstrate a culture of Service Excellence.
19. Perform other duties as assigned.
QualificationsQUALIFICATIONS:
1. High School diploma with emphasis on business courses.
2. Must have at least 5 years combined training as a Regional B.O.M., or Business Office Manager in a skilled facility, one year’s experience in maintenance of billing software.
3. Must be able to conduct meetings and in-service training sessions.
4. Good communication skills, able to relate ideas to others.
5. Must be flexible, detail-orientated, ability to multi-task, meet deadlines and be able to make effective decisions and work as part of a service excellence team.
PHYSICAL REQUIREMENTS:
1. Ability to walk, stand or sit for extended periods of time.
2. Ability to kneel, crawl, reach, and grasp
3. Ability to pull up to 20 lbs.
4. Ability to push up to 50 lbs.
5. Ability to lift up to 50 lbs.
Skills Required
- High school diploma with emphasis on business courses
- Minimum 5 years combined experience as Regional B.O.M. or Business Office Manager in a skilled facility
- At least 1 year experience maintaining billing software
- Experience with electronic billing and remittance advice setup with payers
- Experience handling ADR/Appeals, adjustments, and write-offs per policies
- Ability to develop and deliver training and conduct meetings/in-service sessions
- Strong communication, detail orientation, multi-tasking, decision-making, and teamwork skills
- Supervisory experience (supervise intake staff)
- Familiarity with Medicare, Medicaid, and other insurer billing policies
- Ability to travel to centers as needed
What We Do
Commonwealth Care of Roanoke is a healthcare leader in Virginia, operating twelve modern facilities dedicated to providing compassionate and complete rehabilitation services. Their mission is to improve the lives of patients through individualized and responsive care, utilizing a network of health and rehab centers. They prioritize clinical excellence and strict compliance to ensure that every patient is supported in returning to their best possible health.
