Patient Account Supervisor--Dept of Medicine

Provides directs supervision to activities of a billing department which may include accounts receivable, charge entry, payment posting, credits, and other reimbursement related activities; and other duties as assigned. Will work in multiple areas within the revenue cycle and coordinate work with other supervisors, managers and leadership. Will perform in-depth denial reviews and partner with clinical Division Leadership to develop denial mitigation plans. Will utilize large data files to assess areas of opportunity that support revenue optimization.

 

ESSENTIAL FUNCTIONS 

• Trains and develops team members to improve productivity and high-performance levels. Keeps team members up to date on changes affecting billing and collecting procedures.  Assists in the evaluation of team members.  Trains team members to use on-line computer system, use personal computers for electronic billing, uses CRT’s installed by third party payors.  Understands 1500, billing procedures.  Reviews and resolves problem bills.  Responds to inquiries, audits payments, rejections, and payment vouchers.  Resolves credit balances, adjusts patient accounts, documents account activity.  Coordinates work schedules of team.  Distributes workload to team.  Monitors and controls rejections and error rate.  Assists in handling insurance inquiries from insurance carriers, assists in resolving customer complaints.

 

• Determines what is required for each payor in the spectrum of payors used by the physician to constitute an accurate claim and ultimately a paid bill. Attends special workshops or training sessions for third party payors and intermediaries to maintain current knowledge relative to billing and collecting procedures.

 

• Ensures all bills meet the criteria of a clean claim. Reviews all bills to certify charging is appropriate for the date of service.  Verifies the diagnosis, with the charges to warrant maximum reimbursement.  Processes timely, accurate claims with complete patient information to payors both electronically and on paper.  Bills secondary insurances with the explanation of benefits.

 

• Receives telephone calls, correspondence and performs follow-up inquiries on all third-party accounts.

 

• Maintains and reviews daily PCS work files or aged trial balance report, performs follow-up and resolves any issues by communicating both electronically and by paper with physicians, hospital staff, medical records, insurance companies, etc., to resolve all outstanding balances on patient’s accounts.

EDUCATION and/or EXPERIENCE

• High school diploma or general education degree (GED) preferred
• College experience in related field i.e. business or healthcare etc. preferred
• Minimum 3-5 years comprehensive medical billing experience to include; charge entry, AR follow up and payment posting
• Minimum 2 years supervisory or team leader experience is preferred
• General understanding and application of complex accounting principles