Medical Billing Charge Entry Manager

Optima Medical • Scottsdale, Arizona, United States • 23h ago

About Optima Medical:

Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard. We are seeking a detail-oriented and proactive Medical Billing Charge Entry Manager to lead our Charge Entry department in our growing primary care group. This department is responsible for entering, editing, reconciling, and submitting all primary and secondary electronic claims. As part of the revenue cycle team, you'll play a pivotal role in ensuring the accurate and timely processing of claims, helping us maintain financial health while providing excellent care to our patients.

Key Responsibilities:

Supervision & Oversight: Lead the daily operations of the Charge Entry team, ensuring all provider charge batches are accurately entered, reconciled, and edited in a timely manner. Oversee status and communication of unlocked progress notes.
Claim Entry & Reconciliation: Maintain organized records of charges, including batches entered and pending entry, ensuring all data is accurately captured for submission.
Claim Edits & Adjustments: Perform and assist with claim edits, including ICD to CPT mapping, updating modifiers, CPT crosswalks etc. Collaborate with denials team to improve claim scrubbing edits based on common denial trends.
Accuracy Review: Review medical records and documentation to ensure all coding is accurate and complete. Identify and address errors or inconsistencies in claims, ensuring proper billing to insurance.
Collaboration & Resolution: Help develop and implement billing policies, quality checks, and efficiency improvements. Work closely with Director of Billing, clinic managers, and other billing team members to resolve discrepancies, improve claim accuracy, and streamline workflows.
Compliance: Stay updated on current billing guidelines and help develop internal policies to be followed to maintain compliance.

Qualifications:

Experience: Minimum of 3-5 years of experience in medical billing & coding, preferably primary care specialty with at least 2 years in a supervisory or leadership role.
Knowledge: Strong understanding of charge entry processes, claim edits, and medical coding/billing (ICD-10, CPT, HCPCS).
Attention to Detail: Ability to spot inconsistencies, errors, and discrepancies in charges / claims quickly and accurately.
Leadership: Strong leadership skills with the ability to motivate and guide a team in a fast-paced environment.
Communication Skills: Excellent verbal and written communication skills, able to collaborate effectively with internal teams and external payers.
Tech-Savvy: Familiarity with billing software(s) and Electronic Health Records (EHR) systems, proficient in Microsoft Excel.

Why join our team?