Billing & Insurance Relations Manager

Reports To: Patient Financial Services Management (PFSM) Department Director

Location: Tbilisi

Shift/Hours of Work: Full Time

Job Summary: 

American Hospital Tbilisi (AHT) is looking for a competent Billing & Insurance Relations Manager who will be responsible for directing and coordinating the overall functions of the medical billing and insurance relations to ensure maximization of cash flow while improving patient, physician, and other customer relations.             

Main Job Duties and Responsibilities:

* Oversee the operations of the Billing & Insurance Relations Unit, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management;

* Plan and direct patient insurance documentation, coding, billing and collections, and data processing to ensure accurate billing and efficient account collection;

* Monitor and control the processes including: entering patient insurance information; verifying patient eligibility and benefits for upfront collection on unmet deductibles and co-insurance; reviewing operative reports after procedure/surgery; entering charges accurately according to insurance payors/contracts; submitting clean claims by attaching necessary documentation for payment; follow-up on electronic and paper claims; refunding money owed to patient or insurances;

* Prepare and analyze accounts receivable reports, weekly and monthly financial reports, and insurance contracts; collect and compile accurate statistical reports;

* Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and follow Governmental (State) and payer regulations, guidelines, and requirements; serve as the practice expert and go to person for all coding and billing processes;

* Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures; keep up to date with carrier rule changes and distribute the information within the practice;

* Maintain a working knowledge of all health information management issues and all health regulations;

* Plan, assign, direct, and monitor the work of subordinate staff; analyze and distribute projects, assignments and workloads; evaluate  employee performance; respond to employee grievances and complaints; initiate and coordinate staff selection and training processes; ensure that staff activities comply with organizational expectations;

* Establish and implements unit specific guidelines for effective operations

Qualifications:

Education and experience

* Bachelor’s degree 

* Minimum 3 years of professional experience in Medical Insurance/Healthcare Billing and Collections, with a deep understanding of medical billing rules and regulations

* At least 2 years of supervisory/leadership experience

 Demonstrated Skills and Abilities

* Effective communications, negotiations, and conflict resolutions skills

* Analytical skills

* Leadership skills

* Fluency in Georgian language

* Good command of English

* Customer service to manage respond promptly to customer needs

* Project management skills

* Change management skills

* Ability to optimize the operational processes to achieve objectives

* Time management skills

* Ability to develop, appraise and motivate subordinates

* Team building and management skills

* Crisis management skills

* Risk management skills

If you have any queries regarding this vacancy, please send an email at [email protected].

We would like to thank all candidates in advance for their interest and only those candidates selected for interview will be contacted.