Billing Manager

Job Purpose

The Billing Manager will oversee the AMCE’s billing operations, ensuring accurate and efficient claims processing, managing the revenue cycle, and maintaining compliance with regulatory requirements. The role holder will be responsible for managing a team of billing officers, resolving billing discrepancies, optimizing revenue streams, and collaborating with clinical, administrative, and financial stakeholders to ensure seamless billing processes.

Core Responsibilities

Revenue Cycle Management

• Ensure accurate and timely capture of charges for all services provided, review and verify charge data for completeness and accuracy, assign appropriate codes to services and procedures and monitor and improve charge capture processes to maximize revenue.
• Monitor and manage accounts receivable to ensure timely payment of claims, follow up with payers to resolve billing and payment issues.
• Negotiate contracts with payers to optimize reimbursement rates, monitor contract terms and ensure compliance and identify opportunities to improve contract terms and reimbursement rates.
• Analyze revenue cycle performance metrics, such as days in accounts receivable, collection rates, and denial rates, identify areas for improvement and implement corrective actions and implement strategies to improve revenue cycle efficiency and productivity.
• Ensure compliance with all relevant regulatory requirements, stay updated on changes in regulations and industry standards and implement compliance programs to mitigate risks.
• Identify and resolve billing errors and discrepancies and implement strategies to reduce accounts receivable aging.
• Prepare and submit accurate and timely claims to payers, identify and resolve claim denials and rejections.

Billing Operations

• Implement billing policies and procedures compliant with Nigerian healthcare regulations (e.g., NHIS, LASHMA), ensuring alignment with AMCE’s policies and procedures.
• Monitor and resolve billing errors and discrepancies, utilizing expertise in claims adjudication.
• Supervise billing staff and provide training on billing procedures specific to AMCE.
• Ensure compliance with data protection regulations (e.g., NDPR), and safeguard patient information.
• Perform quarterly audits to identify areas for improvement, ensuring billing accuracy and compliance with industry standards.

Patient Billing and Communication

• Ensure accurate and timely patient registration and demographic data collection, verify insurance eligibility and benefits and update patient information as needed.
• Explain billing statements and insurance coverage to patients, answer patient questions and concerns about billing and insurance and assist patients with financial arrangements, including payment plans and financial assistance.
• Verify insurance eligibility and benefits for each patient encounter, obtain pre-authorization for services as required by insurance plans and appeal denied claims to maximize reimbursement.
• Generate accurate and timely patient bills, post payments and adjustments to patient accounts, follow up on outstanding balances and initiate collection efforts and manage patient financial assistance programs.
• Communicate effectively with patients, insurance companies, and internal staff, resolve patient billing issues and complaints promptly and provide excellent customer service to ensure patient satisfaction.

Financial Analysis and Reporting

• Prepare accurate and timely financial statements, including income statements, statement of financial position, and cash flow statements, ensure compliance with relevant accounting standards (GAAP or IFRS) and regulatory requirements and analyze financial data to identify trends, potential issues, and opportunities.
• Analyze financial variances between actual and budgeted performance, identify the root causes of variances and recommend corrective actions. Prepare variance analysis reports for management review.
• Develop and implement annual budgets and long-range financial plans, monitor budget performance, and identify potential risks and opportunities and prepare financial forecasts and projections.
• Analyze and allocate costs to different departments and services to improve cost efficiency and develop and implement cost-control measures.
• Create and maintain financial models to support strategic decision-making and conduct sensitivity analysis to assess the impact of different scenarios on financial performance.

Educational Requirements

• Bachelor’s degree in Accounting or related field.
• MSc. in a relevant discipline will be an added advantage.

Professional Requirements

• Possession of a professional certification (ICAN, ACCA) is an added advantage.
• Evidence of continuing professional and managerial development.

Experience Requirements

• Minimum 7 years of experience in healthcare billing management.
• Experience with electronic health records (EHRs) and billing systems.
• Experience in revenue cycle management and compliance

Competency Requirements

Knowledge Requirement

• A deep understanding of healthcare reimbursement methodologies, including Medicare, Medicaid, and commercial insurance.
• Knowledge of various types of health insurance plans.
• Understanding of relevant healthcare regulations.
• Knowledge of basic accounting principles and financial analysis.

Skills Requirements

• Problem-Solving
• Analytical Skills
• Communication Skill
• Attention to Detail
• Organizational Skills
• Negotiation Skills
• Leadership Skills
• Technology Skills

Personal Abilities

• Professional attitude towards work
• Shares the AMCE’s vision.
• Proactive and organized.
• Has personal and professional credibility and commands the respect of colleagues and peers. 
• Supportive and approachable and capable of inspiring confidence in staff members
• Strategic thinking and planning
• Emotional intelligence and empathy
• Coaching and development of team members
• Change management and adaptability
• Decision-making and problem-solving

African Medical Centre of Excellence, Abuja (AMCE Abuja) aims to be an Employer of Choice, providing equal opportunity for everyone regardless of their background, gender, race and other protected characteristics.