Manager, Billing & Claims Submission

Job Description:

The Manager, Billing & Claims Submission is responsible for leading claims submission and paper claims functional area for all clients.

• Design and implement effective, efficient and consistent processes and operational policies across the claims submission and paper claims function in all locations.
• Recommend and implement changes to organizational structure, staffing levels, systems, tools, reports, and services to fulfill customer needs in the claims submission and paper claims areas and ensure SLA's are met.
• Manage the claims submission and paper claims functional areas and ensures quality assurance standards and benchmarks are met.
• Partner with Operational and Account Management leaders, responsible for ensuring service level agreements are met for each client in the claims submission and paper claims area, handling escalations in a thorough and timely manner, identifying opportunities for improvement and developing action plans for problem resolution.  
• Recommend and assists in implementing a common set of systems, tools and reports for use by all claims submission and paper claim teams across all state-side locations. In partnership with Help Desk and EDI group defines where claims submission work ends and where EDI work begins and ensures seamless handoff where applicable.  
• Communicate regularly with subordinate managers and functional peer group, as well as external customers or vendors depending upon the job function.
• Perform other duties that support the overall objective of the position.

Education Required:    

• Bachelor's Degree.
• Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:

• 6+ years of experience in revenue cycle management, customer service, claims or related experience.

• Experience in a lead/supervisory role.

Knowledge, Skills & Abilities:

• Knowledge of: Management approaches such as management of workflow, quality review, coaching, and performance management.
• Skill in: Communication, staff development, collaboration.
• Ability to: Explain policies, practices and procedures of the area of responsibility to others within the organization.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.