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Responsible for the daily supervision and coordination of work performed by Billing staff. Responsible for patient accounting and customer service. Provides billing support and guidance to physicians, nurse practitioners, counselors and all clinical staff. Monitors billing activities to ensure and address preventable revenue loss. Works alongside Billing Outsource Company to ensure all services performed are billed appropriately and collected in a timely manner.
Essential Functions:
- Directly supervises the day-to-day activities of Billing staff to ensure work assignments are complete and deadlines are met.
- Interviews patients (both new and established) and completes paperwork regarding insurance, grants and any financial needs. Ensures the patient understands their financial obligation to the organization and keeps detailed records of these transactions.
- Verifies all patient insurance coverage and handles precertification when required by patients plan and keeping them up to date when necessary
- Keep all systems updated with accurate billing information, this includes 3 Advanced MD systems and Methasoft
- Monthly patient self-pay billing
- Daily posting of patient payments
- Daily balancing process, as well as weekly and month billing reports
- Insurance credentialing when needed
- Monthly makes sure that patient accounts receivable is accurate and at a minimum
- Ensure patient services are marked accurately on charge tickets and that tickets are uploaded daily to Billing Company
- Communicates daily with Billing Company on any known issues and works to resolve these in a timely manner
- Communicate with patients regarding any questions and/or concerns they may have regarding their bills and provides resolution
- Evaluates job assignments to determine workload distribution across staff, making changes as necessary.
- Supervises the execution of the Work Plans for direct reports Supervises, trains and evaluates employees job performance. Counsels and documents inappropriate behaviors and unacceptable job performance and makes recommendations for corrective actions.
- Maintains a working knowledge of the ICD-10-CM and CPT/HCPCS coding principles and the AMA/CMS Documentation Guidelines (DGs). Keeps current on any changes to payer-specific reimbursement policies. Serves as a subject matter expert to the providers and administration, responding to questions related to coding and billing issues, payer policies and regulations.
- Provides verbal and written instruction to providers about how to abide by the various payer rules and regulations when reporting their services.
- Reviews record requests from third party payers to evaluate appropriate coding/billing of medical records.
- Ongoing responsibility to identify ways to help address preventable revenue loss.
- Maintains a positive and professional relationship with physicians, clinical, administrative and other related staff.
Marginal Functions:
- Ability to calculate, manipulate and interpret numbers
- Performs other duties as assigned by the Director
Education, Training, and Experience:
Four or more years previous physician office/clinical experience working with accounts receivable required. Previous supervisory experience required. Must possess comprehensive knowledge of ICD-10-CM, CPT and HCPCS coding systems, medical billing functions as well as knowledge of Medicare, Medicaid and other insurance carrier requirements. LME knowledge is a plus. Must have the ability to clearly communicate verbally and in writing with physicians and patients. Must possess strong organization and time management skills and interpersonal skills. Must be able to prioritize and manage multiple work assignments. Demonstrates critical thinking and ability to analyze complex data. Must be able to work cooperatively and effectively with staff from different disciplines on an individual and team basis. Must exercise good judgment and common sense when making decisions. Must demonstrate proficiency with Excel. Knowledge of AdvancedMD is a plus.
Requirements
Ability to sit and concentrate for extended periods of time. Frequent reaching and handling of reports and/or medical records. Ability to work under pressure and meet deadlines.
Machine, Tools, and Equipment:
PC competency required with a working knowledge of Microsoft Word and Excel.
Competency with other automation software tools is required. Competency level must allow the incumbent to develop and use automation tools to improve departments efficiency and effectiveness in completing assignments.
Protected Health Information:
Will limit access to protected health information (PHI) to the information reasonably necessary to do the job.
Will share information only on a need to know basis for work purposes.
Access to verbal, written and electronic PHI for this job has been determined based on job level and job responsibility within the organization. Computerized access to PHI for this job has been determined as described above and is controlled via user ID and password.
Benefits
We offer medical, dental, and vision insurance. We also offer 401k, profit sharing, and PTO/Vacation time.
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