Clinical Billing Manager (Path & Lab)

Clinical Billing Manager

What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in.

The Clinical Billing Manager on our Path & Lab team is responsible for managing and optimizing the professional fee revenue cycle to ensure accurate, timely charge capture, coding, billing, and collections. This role monitors performance metrics, reconciles physician service charges, maintains billing compliance, and serves as a key liaison with physicians, billing vendors, and payors. The position also provides training, reporting, and subject-matter expertise in coding, billing policies, and reimbursement practices.

Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus:

• 100% paid medical premiums for our full-time employees
• Generous time off (holidays, preventative leave day, both vacation and sick time all of which equates to around 37-38 days per year)
• The longer you stay, the more vacation you'll accrue!
• Longevity Pay (Monthly payments after two years of service)
• Build your future with our awesome retirement/pension plan!

We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as...

• Free financial and legal counseling
• Free mental health counseling services
• Gym membership discounts and access to wellness programs
• Other employee discounts including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care
• Plus many more!

Position Summary:

Responsible for ensuring the operational efficiency and effectiveness of the revenue cycle for professional fee income (including charge capture and coding, reconciliation, charge submission, and collections).

Position Key Accountabilities:

1. Ensures prompt submission of charges to billing company. 2. Establishes sound processes for capture and reconciliation of physician service charges. 3. Develops and monitors tracking mechanism to ensure proper and prompt submission and receipt of charge documents. 4. Monitors key performance metrics including but not limited to 1. charge activity (by physician and division) on a weekly basis; 2. elapsed time between dates of service and dates of charge submission; 3. charge document submission and receipt cycle time; 4. coding patterns by specialty and division; and 5. receivables, denials and collections. 5. Ensures that the data entry and charge documents are captured correctly and promptly. 6. Investigates and reports variances from expected levels. 7. Monitors billing provider lists and ensures that profile information is set-up, maintained, and current in the system. 8. Trains new physicians on charge capture and billing processes. 9. Serves as the department's primary resource for all coding and billing questions particularly in the area of Medicaid reimbursement. 10. Serves as primary liaison with billing company for requests of additional information and research documents. 11. May work with Billing Coordination & Compliance dept. on faculty billing & documentation issues, as well as coding compliance training, and policy interpretation. 12. Generates monthly operational reports. 13. Stays current with changes/updates related to standardized and specialty coding conventions, 3rd party payors, and other relevant coding and billing guidelines. 14. Working knowledge of top 3rd party payors. 15. May serve as a liaison with 3rd party payors. 16. Communicates billing policies and procedures to staff. 17. Other duties as assigned.

Certification/Skills:

• Superior working knowledge of insurance reimbursement is required.
• Certified Professional Coder (CPC) by American Academy of Professional Coders (AAPC) required
• Certified Coding Specialist
• Physician-based (CCS-P) by American Health Information Management Association (AHIMA) required
• Registered Health Information Administrator (RHIA) by American Health Information Management Association (AHIMA) required
• Registered Health Information Technician (RHIT) by American Health Information Management Association (AHIMA) required
• Must complete certification within 12 months of employment at UTHSC-H required

Minimum Education:

Bachelor's degree in Business, Healthcare Administration, Health Information Management or related field, or equivalent experience in lieu of degree.

Minimum Experience:

Five years directly related experience.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code 51.215 and Texas Government Code 411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code 117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. 791.4.

Residency Requirement:

Employees must permanently reside and work in the State of Texas.