Billing Officer

Billing Officer

Billing Officer

The Billing Officer will be responsible for accurately and efficiently managing patient billing processes within AMCE. This includes charge capture, claims submission, payment posting, accounts receivable follow-up, and ensuring compliance with international and local billing regulations. The role holder will work to optimize the revenue cycle, minimize claim denials, and provide excellent customer service to patients regarding billing inquiries.

Key Accountabilities/Responsibilities

• Billing & Claims Processing
• Prepare and submit accurate invoices to patients, insurance companies, and third-party payers. Verify patient eligibility and insurance coverage prior to billing. Ensure compliance with international billing regulations (e.g., HIPAA, GDPR, local healthcare laws). Resolve discrepancies in billing and claims submissions. Follow up on unpaid claims and denials, initiating appeals when necessary. Maintain up-to-date knowledge of payer policies and billing codes (ICD-10, CPT, HCPCS).
• Financial Reconciliation
• Reconcile daily billing transactions with accounting records. Investigate and resolve discrepancies in payments and adjustments. Generate financial reports on billing performance (e.g., ageing reports, collection rates). Collaborate with the finance team to ensure accurate revenue recognition. Monitor and report on bad debt and write-offs. Ensure timely refunds for overpayments.
• Patient & Insurance Communication
• Respond to billing inquiries from patients and insurance providers in a timely manner. Educate patients on payment options, financial assistance, and insurance processes. Liaise with insurance companies to resolve claim disputes. Document all communications and follow-ups in the billing system. Provide exceptional customer service to minimize billing-related complaints. Escalate complex billing issues to management when necessary.
• Compliance & Audit Readiness
• Ensure adherence to international healthcare billing regulations. Maintain proper documentation for audits and compliance reviews. Conduct internal audits to identify billing errors and implement corrective actions. Stay updated on changes in billing laws and payer policies. Report any fraudulent billing activities to the billing manager. Participate in external audits and provide required documentation.
• System & Process Improvement
• Identify inefficiencies in the billing process and recommend improvements. Work with IT to optimize billing software and automation tools. Train staff on new billing procedures and system updates. Implement best practices to reduce claim denials and rejections. Monitor key performance indicators (KPIs) to measure billing efficiency. Contribute to the development of billing policies and procedures.
• Collections & Revenue Cycle Management
• Monitor accounts receivable and follow up on overdue payments. Coordinate with collection agencies for delinquent accounts. Analyze trends in payment delays and implement mitigation strategies. Ensure timely posting of payments to patient accounts. Minimize revenue leakage through proactive account management.
• Inter-departmental Collaboration
• Work closely with clinical staff to ensure accurate charge capture. Coordinate with the admissions team to verify insurance eligibility. Assist the finance team in month-end closing processes. Provide billing insights to support strategic financial decisions. Participate in interdepartmental meetings to improve revenue cycle efficiency. Support the implementation of new healthcare services from a billing perspective.
• Reporting & Analytics
• Generate monthly reports on billing accuracy, denial rates, and collections. Analyze data to identify trends and areas for improvement. Present findings to management with actionable recommendations. Track key metrics such as clean claim rates and days in A/R. Use analytics to forecast revenue and billing performance. Ensure data integrity in all billing-related reports.

Must have skills

• Medical billing codes
• Financial reporting and reconciliation

Qualifications

• Bachelor’s degree in Accounting, Finance, Business Administration or a related field.Relevant accounting certification (e.g ACA, ACCA)Evidence of continuing professional and managerial development.In-depth knowledge of billing and coding processes in the healthcare sector.Familiarity with healthcare regulations, including HIPAA and insurance policies.Understanding of revenue cycle management and payment reconciliation.Awareness of best practices in billing process optimization.Proficiency in billing software and financial management systems.Strong understanding of medical billing codes (e.g., ICD-10, CPT) and insurance processes.Knowledge of financial reporting and reconciliation.