Updated: 4/26/2012
BILLING MANAGER, PBODescription:
General Overview
Working under the general direction of the Associate Director, Operations Manager, and Team Leads of the Group Practice Management department (GPM) in the Professional Billing Office (PBO), the Billing Manager serves as the primary contact between a group practice and the PBO for all aspects relating to the billing of professional services. Working closely with the Administrative Director and physician leadership of a practice, the Billing Manager is responsible for the proactive management of the billing process and the client relationship full assessment and understanding of the practices revenue cycle, which includes a thorough understanding of systems, process and service specific coding and billing requirements proactively identifying opportunities for revenue cycle improvement initiatives and developing and executing these plans providing practice and PBO Management with interpretation of standard operational, financial, billing and budget statistics on a monthly basis. The MGPO Professional Billing Office is the central billing office for physician practices affiliated with Massachusetts General Hospital in Boston, Massachusetts.
Major Duties
Establishes and manages effective ongoing communication with assigned physician practice(s) to identify and address business needs; provides guidance and timely responses to customer service questions and requests; conducts regular meetings with practice staff. Communicates with practice(s) within the framework of the Revenue Cycle. Provides analysis and context for monthly performance data. This includes projections and comparison to budget figures. Provides analysis and context for monthly performance data
Effectively manages group or practices expectations regarding financial performance. Maintains ongoing issues and priority list for practice/PBO. Completes analysis of issues for action, presents this information and implements or supervises action plans. Prioritizes with practice MDs or Directors on key performance issues. Proactively identifies sources of issues and communicates these to the appropriate parties. Provides practice(s) with updates on new initiatives within the PBO designed to improve billing performance
Assists practice with statistical analysis. Consults with Management Team to identify issues and trends that contribute to variances and below par performances. Makes recommendations to address issues
Provides practice(s)/PBO Management Team with statistical reports including but not limited to:
total co-payment collections
total encounter discrepancies
interface edits
service to post date lag time
charges held due to provider credentialing
number of missing referrals
number of cash deposit discrepancies
number of outstanding provider applications
monthly write-offs
payer rejections
Understands the implication of each element in the revenue cycle, communicates this to group/practice to engender an appropriate response. Provides interpretation to clients/PBO Management. Develops interventions and initiates actions
Focuses practice(s) on issues that will positively impact financial performance. Provides updates on global issues regarding coding and reimbursement practice(s). Assesses impact of new regulations or codes from a coding, compliance and reimbursement perspective. Develops expertise for assigned practice(s). Works with practice leadership on annual budgeting, forecasting and analysis for potential new business opportunities
Supports the integration of new physicians/practice(s) into the PBO by providing professional charges by CPT code to MIS for dictionary modifications; assisting in the orientation/training of practice staff (i.e. batch processing, time of service payments, referral management, co-pay
Qualifications:
Company Profile:
Founded in 1811, Massachusetts General Hospital is the third-oldest general hospital in the country, and the oldest and largest in New England. The 907-bed world-renowned medical center offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. The largest teaching hospital of Harvard Medical School, MGH is on the cutting edge of patient care, research and medical education. It is the largest nongovernment employer in the city of Boston, with more than 21,500 employees.
MGH is among the leading medical institutions continuously recognized by U.S. News & World Report's annual honor roll of America's best hospitals. In 2009, MGH ranked fifth nationally, with MGH Psychiatry ranking first in that specialty for the 14th consecutive year. MGH has been named to the list since the publication began conducting the survey in 1990.
In 2008, MGH again was named a Magnet hospital by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. The Magnet Recognition Program recognizes health care organizations that provide the best in nursing care and to uphold the tradition of excellence in professional nursing practice. MGH was the first Massachusetts hospital to earn the Magnet designation in 2003.
MGH has repeatedly been named an employer of choice. Most recently, it was named to The Globe 100, a list of the top employers in Massachusetts compiled by The Boston Globe. The hospital has also earned a spot on Conceive magazine's 2009 list of the Top 50 Workplaces for Prospective Parents.
A career with MGH means you'll be part of a rich legacy of providing top-quality patient care and an integral part of ensuring that our success continues. Located in Boston, MGH is accessible by several MBTA lines. Our benefits and perks are outstanding and include health/dental insurance, a retirement plan, 403b, paid time off, tuition reimbursement, childcare center and a fitness center. There is only one MGH! For more information, please visit us at http://www.mghcareers.org.
Massachusetts General Hospital is an Equal Employment/Affirmative Action Employer.
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