Planned Parenthood of Illinois
Manager of Billing and Credentialing
Planned Parenthood of Illinois, Chicago, Illinois, United States, 60601
Manager of Billing and Credentialing
The Manager of Billing and Credentialing is responsible for ensuring that all Health Center services are billed, collected, and reconciled, ensuring that all providers and locations are credentialed and re-credentialed, and supervising effective account receivables processes through accurate patient account maintenance, statement generation, and timely follow up. This position provides supervisory support across multiple teams that contributes to charge capturing, billing, collections and provider credentialing. Essential Functions: The Manager of Billing and Credentialing serves as the supervisor responsible for health center billing, Epic Workques, charge error resolution, and, patient customer service and follow up. This role also serves as the Health Center point-of-contact for provider credentialing and follow up. The Manager is charged with proactively ensuring patient account satisfaction and helping ensure that Planned Parenthood of Illinois' (PPIL) practices remain in alignment with state, federal, and payer billing compliance. Supervises the Contracts and Credentialing Team and ensures accuracy by applying consistent technical knowledge and follow up in daily workflow processes Supervises the Billing/Revenue Integrity Team and ensures that all services that are received are reimbursed Serves as Revenue Cycle Management (RCM) Liaison with PPIL Vendors to resolve Billing and Credentialing scopes through timely follow up Ensures that all Health Center services are charged and that all Pre-Bill errors are resolved daily in the Epic Workques. Ensures that accurate notes and complete follow up statuses are listed on patient accounts. Ensures the maintenance and updating of the PPIL Fee schedules. Ensures the maintenance and updating of the PPIL Charge master pricing and Coding by applying consistent technical knowledge and follow up Ensures Team compliance with State, Federal and payer rules to prevent external audits and revenue loss Ensures timely processing and resolution of Contact Center, Vendor and patient request. Ensures up to date documentation is maintained in the patient accounting system to meet quality assurance and productivity standards. Serves as the Internal Project Manager for Revenue Cycle Audits and Coding Training Assist as an RCM Payer Relations "problem solver" on all denials/revenue loss related task and ensures follow up Proactively Ensures Team PPFA Financial performance metrics are met by running EPIC BI report and monitoring Epic dashboards to ensure team guidance to prevent revenue loss Other Functions: Proactively stays up to date on Revenue Cycle standards, Coding and Credentialing through self- initiated professional development to ensure accountability in performance of the duties of the role. Supports and Implements the Directives of the Director of Payer Relations and Revenue Cycle Management to ensure team compliance with Department Policies and Procedures. Coordinates with Health Center staff to ensure that all clinical documents in the EHR are received and encounters are closed daily with reconciliation. Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows Facilitate training and onboarding of new teammates as well as ongoing training and education for established team members throughout the State of Illinois. Through these activities demonstrate an understanding of and commitment to PPIL core values of access, activism, care, confidentiality, diversity, excellence, integrity, respect, self-determination, and stewardship; practice these values in relations with internal and external customers Perform other duties as assigned. Supervisor: Director of Payer Relations and Revenue Cycle Management Status: Full-time. Exempt from the overtime provisions of the wage and salary regulations. Physical Demands: While performing the duties of this job, the employee is regularly required to stand, walk, talk, read, see and hear. The employee is frequently required to use hands and fingers to type, handle, or feel and reach. The employee is regularly required to sit. The employee must occasionally lift and/or move up to 25 pounds. Work Environment: The position will be a hybrid model of remote work and on-site weekly. This position requires traveling to various Health Centers statewide periodically therefore a personal vehicle, a valid Illinois driver's license, and auto insurance in accordance with agency liability standards is required. $75,000 - $75,000 a year Planned Parenthood works affirmatively to include diversity among its workforce and does not discriminate in the selection of its staff based on factors including but not limited to race, color, religion, sex, national origin, age, sexual orientation, gender identity, disability, income, marital status or any other characteristic protected under federal, state or local law. We encourage you to apply anyway if you may be exactly who we are looking for!
The Manager of Billing and Credentialing is responsible for ensuring that all Health Center services are billed, collected, and reconciled, ensuring that all providers and locations are credentialed and re-credentialed, and supervising effective account receivables processes through accurate patient account maintenance, statement generation, and timely follow up. This position provides supervisory support across multiple teams that contributes to charge capturing, billing, collections and provider credentialing. Essential Functions: The Manager of Billing and Credentialing serves as the supervisor responsible for health center billing, Epic Workques, charge error resolution, and, patient customer service and follow up. This role also serves as the Health Center point-of-contact for provider credentialing and follow up. The Manager is charged with proactively ensuring patient account satisfaction and helping ensure that Planned Parenthood of Illinois' (PPIL) practices remain in alignment with state, federal, and payer billing compliance. Supervises the Contracts and Credentialing Team and ensures accuracy by applying consistent technical knowledge and follow up in daily workflow processes Supervises the Billing/Revenue Integrity Team and ensures that all services that are received are reimbursed Serves as Revenue Cycle Management (RCM) Liaison with PPIL Vendors to resolve Billing and Credentialing scopes through timely follow up Ensures that all Health Center services are charged and that all Pre-Bill errors are resolved daily in the Epic Workques. Ensures that accurate notes and complete follow up statuses are listed on patient accounts. Ensures the maintenance and updating of the PPIL Fee schedules. Ensures the maintenance and updating of the PPIL Charge master pricing and Coding by applying consistent technical knowledge and follow up Ensures Team compliance with State, Federal and payer rules to prevent external audits and revenue loss Ensures timely processing and resolution of Contact Center, Vendor and patient request. Ensures up to date documentation is maintained in the patient accounting system to meet quality assurance and productivity standards. Serves as the Internal Project Manager for Revenue Cycle Audits and Coding Training Assist as an RCM Payer Relations "problem solver" on all denials/revenue loss related task and ensures follow up Proactively Ensures Team PPFA Financial performance metrics are met by running EPIC BI report and monitoring Epic dashboards to ensure team guidance to prevent revenue loss Other Functions: Proactively stays up to date on Revenue Cycle standards, Coding and Credentialing through self- initiated professional development to ensure accountability in performance of the duties of the role. Supports and Implements the Directives of the Director of Payer Relations and Revenue Cycle Management to ensure team compliance with Department Policies and Procedures. Coordinates with Health Center staff to ensure that all clinical documents in the EHR are received and encounters are closed daily with reconciliation. Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows Facilitate training and onboarding of new teammates as well as ongoing training and education for established team members throughout the State of Illinois. Through these activities demonstrate an understanding of and commitment to PPIL core values of access, activism, care, confidentiality, diversity, excellence, integrity, respect, self-determination, and stewardship; practice these values in relations with internal and external customers Perform other duties as assigned. Supervisor: Director of Payer Relations and Revenue Cycle Management Status: Full-time. Exempt from the overtime provisions of the wage and salary regulations. Physical Demands: While performing the duties of this job, the employee is regularly required to stand, walk, talk, read, see and hear. The employee is frequently required to use hands and fingers to type, handle, or feel and reach. The employee is regularly required to sit. The employee must occasionally lift and/or move up to 25 pounds. Work Environment: The position will be a hybrid model of remote work and on-site weekly. This position requires traveling to various Health Centers statewide periodically therefore a personal vehicle, a valid Illinois driver's license, and auto insurance in accordance with agency liability standards is required. $75,000 - $75,000 a year Planned Parenthood works affirmatively to include diversity among its workforce and does not discriminate in the selection of its staff based on factors including but not limited to race, color, religion, sex, national origin, age, sexual orientation, gender identity, disability, income, marital status or any other characteristic protected under federal, state or local law. We encourage you to apply anyway if you may be exactly who we are looking for!