Children's National Hospital
Manager Hospital Billing & Collections
Children's National Hospital, Silver Spring, Maryland, United States, 20900
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Manager Hospital Billing & Collections
role at
Children's National Hospital Overview
Base pay range:
$77,646.40/yr - $129,396.80/yr Manages all aspects of hospital billing and DNFB. Responsible for ensuring compliance with regulatory bodies as well as payer-specific requirements. Understands hospital reimbursement methodologies and evaluates any billing changes against expected reimbursement. Ensures goals are achieved by maintaining fluent processing for timely claim submission. Identifies, monitors and reports issues as they arise and implements appropriate resolutions. Identifies and coordinates performance improvement initiatives with internal teams and payers to reduce denials and underpayments. Works with all levels of staff, management and payers to improve revenue cycle performance. Well versed in all aspects of the revenue cycle and the impact to billing. Collaborates with the professional billing manager to understand the impact of system updates and process changes on their team. Demonstrates analytical problem solving, attention to detail, and a focus on compliance, key performance indicators and efficiency. Fosters a positive, collaborative work environment and participates in planning, implementation, management and evaluation of service/department activities in accordance with accepted national standards and hospital policies. Minimum Education
Bachelor's Degree (Required) Minimum Work Experience
3 years Related and progressive experience (Required) And 2 years Management experience in a healthcare or related field (Required) Required Skills/Knowledge
Excellent oral and written communication Excellent computer skills, preferably with Access and Excel Strong analytical skills Well versed in all aspects of the revenue cycle Analytical problem solver Focused on compliance, key performance indicators and efficiency Strong ability to quickly assess current procedures and develop and implement resolutions Demonstrate employer of choice values such as fostering collaboration, team spirit and providing a positive motivating environment Functional Accountabilities
Staff Supervision
Manage human resource activities of assigned team members, including selection and termination, training and development, evaluation and scheduling Develop staff qualifications and performance criteria; update Director on staff performance and progress toward criteria; participate in employee development criteria and selection Update staff with relevant information from Hospital and CNMA via written communication or staff meetings Represent staff interests in committees Coordinate work flow of staff, considering workload, priorities and available resources; promote an environment to support and recognize team and individual contribution Document policies and procedures; communicate development and change to staff; contribute to ongoing review of policies and procedures Operations Management
Lead or co-lead denial work groups; manage reports, data and root cause issue & resolution report; ensure progressive action to reduce denials & underpayments Coordinate projects related to payer performance and work with Managed Care and others to address issues Identify potential billing compliance issues, assess risk and research resolutions; work closely with Compliance Department to prioritize and correct; represent Business Operations concerns at meetings with other departments Work with Federal, State, and local authorities in reviewing regulatory issues that affect submission and adjudication of bills Support decision making process with operational data and information Implement strategic plan through management of day to day operations of department/service area; troubleshoot operational issues/barriers; collaborate with Director on significant operational issues Accounts Receivable Management
Take an active role in reviewing Accounts Receivable to identify problems and resolve issues; monitor patient information data entry for quality assurance; follow up on performance issues with management Monitor accounts daily to maximize reimbursement opportunities; develop tools to assist staff in efficiency and effectiveness Audit managed care contract compliance and payer performance regarding reimbursement; report findings and implement corrective action Manage recoveries of underpayments/appeals using internal and external resources; provide documentation and reports Review & report denial trends and identify internal and external causes; initiate process improvement initiatives Manage bad debt process to ensure compliant, timely repayment; manage all vendor placements and related processes Develop and maintain communication with third party payers; stay updated on managed care contractual requirements and payer policies related to denials and reimbursement Billing and Prebilling Management
Manage facility billing team; ensure timely, accurate and compliant billing of accounts receivable; manage and report all prebilling functions including DNFB for IP & OP; ensure timely reconciliation of authorizations Oversee daily import/export processes with STAR and TSH acknowledgement reports; monitor payer report assignments and correction/rebilling of denied claims Monitor changes in daily failed volume and payer mix relative to staff assignments Research Federal, CPT, ICD-9, HIPAA and local billing standards for 837 and UB92 Communicate requirements to interested departments and apply billing standards to Hospital Claims Processing Collaborate with Managed Care Department to resolve payer-related billing issues Organizational Accountabilities
Includes teamwork/communication, performance improvement/problem-solving, cost management/financial responsibility, and safety. Locations
Primary Location: Maryland-Silver Spring; Work Location: Tech Hill Job Details
Job Function: Health Care Provider; Industries: Hospitals and Health Care; Position Status: Regular; Shift: Day; Work Schedule: 8-5pm Job Posting: Sep 4, 2025, 9:56:09 PM Full-Time Salary Range: 77646.4
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Manager Hospital Billing & Collections
role at
Children's National Hospital Overview
Base pay range:
$77,646.40/yr - $129,396.80/yr Manages all aspects of hospital billing and DNFB. Responsible for ensuring compliance with regulatory bodies as well as payer-specific requirements. Understands hospital reimbursement methodologies and evaluates any billing changes against expected reimbursement. Ensures goals are achieved by maintaining fluent processing for timely claim submission. Identifies, monitors and reports issues as they arise and implements appropriate resolutions. Identifies and coordinates performance improvement initiatives with internal teams and payers to reduce denials and underpayments. Works with all levels of staff, management and payers to improve revenue cycle performance. Well versed in all aspects of the revenue cycle and the impact to billing. Collaborates with the professional billing manager to understand the impact of system updates and process changes on their team. Demonstrates analytical problem solving, attention to detail, and a focus on compliance, key performance indicators and efficiency. Fosters a positive, collaborative work environment and participates in planning, implementation, management and evaluation of service/department activities in accordance with accepted national standards and hospital policies. Minimum Education
Bachelor's Degree (Required) Minimum Work Experience
3 years Related and progressive experience (Required) And 2 years Management experience in a healthcare or related field (Required) Required Skills/Knowledge
Excellent oral and written communication Excellent computer skills, preferably with Access and Excel Strong analytical skills Well versed in all aspects of the revenue cycle Analytical problem solver Focused on compliance, key performance indicators and efficiency Strong ability to quickly assess current procedures and develop and implement resolutions Demonstrate employer of choice values such as fostering collaboration, team spirit and providing a positive motivating environment Functional Accountabilities
Staff Supervision
Manage human resource activities of assigned team members, including selection and termination, training and development, evaluation and scheduling Develop staff qualifications and performance criteria; update Director on staff performance and progress toward criteria; participate in employee development criteria and selection Update staff with relevant information from Hospital and CNMA via written communication or staff meetings Represent staff interests in committees Coordinate work flow of staff, considering workload, priorities and available resources; promote an environment to support and recognize team and individual contribution Document policies and procedures; communicate development and change to staff; contribute to ongoing review of policies and procedures Operations Management
Lead or co-lead denial work groups; manage reports, data and root cause issue & resolution report; ensure progressive action to reduce denials & underpayments Coordinate projects related to payer performance and work with Managed Care and others to address issues Identify potential billing compliance issues, assess risk and research resolutions; work closely with Compliance Department to prioritize and correct; represent Business Operations concerns at meetings with other departments Work with Federal, State, and local authorities in reviewing regulatory issues that affect submission and adjudication of bills Support decision making process with operational data and information Implement strategic plan through management of day to day operations of department/service area; troubleshoot operational issues/barriers; collaborate with Director on significant operational issues Accounts Receivable Management
Take an active role in reviewing Accounts Receivable to identify problems and resolve issues; monitor patient information data entry for quality assurance; follow up on performance issues with management Monitor accounts daily to maximize reimbursement opportunities; develop tools to assist staff in efficiency and effectiveness Audit managed care contract compliance and payer performance regarding reimbursement; report findings and implement corrective action Manage recoveries of underpayments/appeals using internal and external resources; provide documentation and reports Review & report denial trends and identify internal and external causes; initiate process improvement initiatives Manage bad debt process to ensure compliant, timely repayment; manage all vendor placements and related processes Develop and maintain communication with third party payers; stay updated on managed care contractual requirements and payer policies related to denials and reimbursement Billing and Prebilling Management
Manage facility billing team; ensure timely, accurate and compliant billing of accounts receivable; manage and report all prebilling functions including DNFB for IP & OP; ensure timely reconciliation of authorizations Oversee daily import/export processes with STAR and TSH acknowledgement reports; monitor payer report assignments and correction/rebilling of denied claims Monitor changes in daily failed volume and payer mix relative to staff assignments Research Federal, CPT, ICD-9, HIPAA and local billing standards for 837 and UB92 Communicate requirements to interested departments and apply billing standards to Hospital Claims Processing Collaborate with Managed Care Department to resolve payer-related billing issues Organizational Accountabilities
Includes teamwork/communication, performance improvement/problem-solving, cost management/financial responsibility, and safety. Locations
Primary Location: Maryland-Silver Spring; Work Location: Tech Hill Job Details
Job Function: Health Care Provider; Industries: Hospitals and Health Care; Position Status: Regular; Shift: Day; Work Schedule: 8-5pm Job Posting: Sep 4, 2025, 9:56:09 PM Full-Time Salary Range: 77646.4
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