Supervisor, Medical Billing - Healthcare Claims

Job Family:

PFS General

Travel Required:

Up to 10%

Clearance Required:

None

What You Will Do:

The Billing Supervisor - Healthcare Claimsis responsible for the daily operations of billing and works closely with Information Systems, Medical Records, Patient Access and all Ancillary Departments to ensure compliance/ regulatory and accuracy of all billings. Responsible for the supervision of billers, billing systems and billing processes. The Billing Supervisor reports directly to an Operations Manager or Director level position and may perform any and all related job duties as assigned.

This position is classified under a Hybrid schedule working two days in the San Marcos, CA office and three days from home.

Leadership and Training:

• Oversee multiple client billing operations and billing systems across multiple markets within the US.

• Ensures that all employees know and understand all State and Federal Rules and Regulations.

• Provide a working environment which allows employees to communicate ideas for improvement to department. Whenever possible request employee input on policies and procedures that may affect or impact the way their job is performed.

• Allow employees to attend seminars which will enhance productivity and knowledge.

• Ensures employees have all the tools necessary to achieve the goals set.

• Hire and develop staff as departmental needs dictate.

Billing:

• Works with all departments to ensure accuracy of CPT, HCPCS and Revenue Codes.

• Provide departments with Medicare and other payer updates, notices and coverage changes which affect both billing and reimbursement.

• Reviews billing process and systems to ensure the most effective methods are maintained to meet both departmental and facility goals.

• Institutes changes in techniques and processes as necessary.

• Works with IT to ensure that all UB04/837 FTP transfers are successfully completed daily to ensure accurate and timely billing is maintained.

• Ensures bill hold in electronic systems meets established goal.

• Works with Ancillary Departments, Patient Access, Medical Records and Information Systems to ensure clean claim rate meets established goals.

• Works with both electronic billing vendor and payers to resolve billing issues.

• Ensures that employees have access to all tools.

• Reviews 2% of billings for both quantity and quality. 

Compliance:

• Educates and ensures that all employees understand Compliance and appropriate procedure for reporting compliance issues for State, Federal and HIPAA.

• Attends pertinent seminars, internal and external and shares obtained information with staff and other appropriate departments.

• Reviews and maintain JCAHO requirements for billing. 

Reporting:

• Responsible for the weekly Key Indictor Reports and Accomplishments Reports which are due every Monday by 12:00pm.

• Send billing error report to departments daily.

• Maintain logs by department for claims issues in hold status.

• Daily electronic and paper claim report.

• Other reports as requested by management.

• Weekly report of Late Charge to Departments.

What You Will Need:

• Requires a Bachelor's Degree and a minimum 5 years of prior relevant experience or an Associates Degree and 7 years of prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree).

• Experience coming from the following sectors: healthcare, insurance, business, finance or customer service.

• Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.

What Would Be Nice To Have:

• Billing experience with a healthcare provider or an outsourcing company.

• Previous experience installing/utilizing Change Health, Waystar, SSI, and Epic claims scrubber would be beneficial, but not required.

• Previous experience with Cerner, Epic, Allscripts, and Medhost would be beneficial, but not required.

• PC skills in a Windows environment. 

• Knowledge and utilization of desktop applications to include Word and Excel.

• Previous s