At OrthoCarolina, our team is our greatest asset and the foundation of our success; we share a common passion for making lives better. We are a diverse group of individuals, accountable to each other through the backbone of our beliefs: trust, honesty and mutual respect; ensuring our voice is heard. Our positive environment supports individual growth and a sense of belonging. Our employees work together to uphold the standards of excellence and promote and environment of teamwork throughout the organization.

If these attributes align with the job culture you are seeking - then OrthoCarolina might be the right fit for you!

OrthoCarolina is currently seeking an Manager, Medical Billing Data Coordination to join its Medical Billing Business Services team.

This position is a hybrid schedule with rotating days in the office depending on department needs.

The Manager, Data Coordination will oversee the Data Coordination Department by effectively monitoring the daily workflow and processes of the Data Coordinators. The manager is responsible for the transmission and reconciliation of all payment files related to lockbox, insurance EFT/ERA, and clinic payments. This role requires the candidate to have an understanding of various insurance carriers, including Medicare, Medicaid, Workers' Compensation, HMOs, contracted and non-contracted plans. Duties include:

• Responsible for working with bank and IT to coordinate any changes with file transmission or the establishment of any new file transfer processes.
• Assists in answering inquiries from the various departments within the Business office and OrthoCarolina practices and managing all cash receipts.
• Monitors the Auto Post charge/payment files and ensures that Auto Post batches are reconciled daily.
• Oversees daily reconciliation of batches/deposits from all locations.
• Maintains updated knowledge of all of the Data Coordination responsibilities and develops accurate and efficient policies and procedures.
• Development of ongoing quality assurance process.
• Performs daily QA of Data Coordinators work.
• Loads all support tickets related to remit processes with Epic and implements logic changes to improve efficiency.
• Submits all insurance applications related to ERA/EFT processing.
• Validates that all EFT payments have been successfully downloaded and reconciled.
• Planning organized, and optimized reconciliation of payer explanation of benefits (EOB), explanation of review (EOR), remittance advice (RA), and Electronic Remittance Advice (ERA-835) for timely payment posting and aging requirements.
• Evaluate remittance errors to ensure accuracy and efficiency by analyzing documentation for discrepancies while monitoring payment types and amounts trends.
• Responsible for coordinating the implementation of new vendors and insurance payer related to electronic payment processing.
• Identify payers utilizing paper methods and report for ERA/EFT transition.

This position requires the ability to work in a fast-paced environment. The candidate should be able to recognize issues and effectively resolve them as well as communicate all issues to the Director of Revenue Cycle. This position will require the reporting of all KPI metrics and will be accountable for the adherence of strict metrics.

A career at OrthoCarolina will provide you with opportunities for career advancement, dedicated peer support, and continuing education. Our company is committed to providing our employees with the utmost positive work environment. Benefits offered include:

• Competitive salary package
• Health, Dental, and Vision insurance
• Health Savings Account
• Life insurance
• Short/Long term disability insurance
• Tuition Reimbursement
• 401(k) retirement plan
• Profit sharing plan

OrthoCarolina is one of the nation’s leading independent academic orthopedics practices serving North and South Carolina and the Southeast since 1922. OrthoCarolina provides compassionate and comprehensive musculoskeletal care including operative and non-operative care, diagnostic imaging and rehabilitative therapy. Widely known for musculoskeletal research and training, OrthoCarolina physicians have specialized expertise in foot and ankle, hip and knee, shoulder and elbow, spine, sports medicine, hand, pediatric orthopedics, and physical medicine and rehabilitation. We commit to improving the lives of all we serve, by providing premier patient care and compassionate, personalized service. Over 300 OrthoCarolina providers see more than one million patient visits throughout western North Carolina each year.

Education/Experience:

• Associate degree required; Bachelor’s degree preferred.
• Eight (8) years of Revenue Cycle experience.
• 2 – 3 years of Epic Experience, highly preferred
• 2-3 years’ experience within a supervisory role.
• Extensive knowledge of medical payment data entry
• Knowledge of Government and Commercial payment regulations and guidelines
• Knowledge of ICD-10, CPT code, EOBs, financial reports, state and payer specific rules
• Advanced Microsoft Outlook, Word, Excel skills and Pivot table.

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