Job Summary
The Manager is responsible for overseeing end-to-end hospital billing and accounts receivable operations related to UB04 claims. The role includes managing denial resolution, claims follow-up, team performance, client communication, compliance, and revenue cycle optimization.
Key Responsibilities
- Manage hospital billing operations for UB04 claims.
- Lead AR follow-up and denial management teams.
- Monitor aging reports, denial trends, and productivity metrics.
- Ensure timely submission and resolution of claims.
- Handle escalations related to Medicare, Medicaid, HMO, PPO, and commercial payers.
- Analyze EOBs, denials, underpayments, and reimbursement issues.
- Maintain SLA, quality, and productivity targets.
- Conduct team training, coaching, and performance reviews.
- Coordinate with clients and internal stakeholders for process improvements.
- Ensure compliance with HIPAA and payer guidelines.
- Prepare MIS reports and operational dashboards.
Required Skills
- Strong knowledge of:
- UB04 claim forms
- Revenue Cycle Management (RCM)
- Denial Management
- Insurance Follow-up
- Medicare/Medicaid guidelines
- ICD-10, CPT, HCPCS basics
- Leadership and people management skills.
- Good analytical and communication abilities.
- Expertise in hospital billing workflows and payer policies.
- Experience with EPIC/Cerner/Meditech preferred.
Eligibility
- Graduate/Postgraduate.
- Typically 6–10+ years in US Healthcare RCM.
- 2–4 years in Assistant Manager/Manager role.
- Experience in Hospital Billing (UB04 mandatory).
