BASIC PURPOSE OF THE JOB

To ensure staff and properly trained and following proper office policies and procedures for billing and collections for all offices.

REPORTS TO

• Director - Business Office

JOB REQUIREMENTS

Supervisory Responsibilities: YES

Minimum Education: High School Diploma/GED

License/Certification Required: None

Minimum Work Experience: Hospital billing and collection experience preferred. Hospital or insurance contract experience preferred.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent customer service skills and ability to work well with a team required.  Familiar with rules and regulations of CMS and other third party payers to ensure proper set up of contract and works with billing staff to ensure clean claims on first time submission. Ability to work with insurance companies to ensure timely payment of claims and address payment variances.  Able to lead and train staff for optimum performance of team. Work with Contract team at time of contract renewals to address contract compliance issues. Comfortable in working with PC, file downloads, balancing skills. Able to problem solve.  Accuracy of posting key to proper follow up of patient accounts

DUTIES AND RESPONSIBILITIES

• Processes all bills on the day they are received: If unable to process, creates a note posted in the system explaining delay. Reports billing problems to team leader to ensure timely correction of issues. When in doubt, references policies and procedures or consults team leader. Stays current with specific insurance company requirements to ensure proper submission of first claim (clean claim). Requests new billing edits/process changes when needed to ensure clean claims.
• Follows up on accounts per departmental guidelines. Maintains acceptable AR levels for areas of responsibility. Works credits in a timely manner.
• Works all insurance rejections in a timely manner: Worked the day they are received. Offers solutions for repeat issues for long-term solution. Appeals denials as needed. Communicates electronically with payer when possible to ensure proper audit trail to dispute timely filing, issues with proper response, etc.
• Works effectively with office managers/teams to ensure a seamless process flow between departments and the revenue cycle: Notifies team lead of problems and trends by office to help solve issues. Notifies team lead of exception behaviors so we can reward those efforts
• Creates a team environment to problem-solve issues with all teams. Creates notes that are of a nature they can be shared with the customer or appropriate for use in a legal document. Documents accounts properly. All interactions require a note unless there is a financial transaction that speaks for itself, posting payment, adjustment, etc.
• Attends all required safety training and CBL requirements: Attends all educational programs as needed. Practices safe lifting and body mechanic procedures. Maintains a safe and clean work area. Can answer questions related to training and/or knows where to find information for all safety training
• Provides teachable moments for all staff and coworkers. Captures and e-mails screen prints to proper managers for follow-up and additional training. Specific examples will help assist in that process.
• Provides daily leadership to team: Reassigns work as needed to meet the demands of the day. Maintains team schedule and follows the established process with manager to ensure proper coding of timecards in Kronos. Assists staff as needed. Assists/complets Annual Performance Reviews before date due out of respect for staff.
• Leads by example: Serves as a role model for all staff in how work is completed; how to treat co-workers and families. Privately discusses with team mates when they see issues relating to showing respect and dignity to any of our customers or co-workers. Ensures privacy for staff when addressing work related issues or concerns
• Works with team leaders/managers to strengthen processes and problem-solve issues. Manages all activities to ensure quality services are provided in an efficient and effective manner as observed by Manager/Director. Works to improve quality of services provided by the department.
• Maintains professional composure and confidence during stressful situations
• Maintains confidentiality of all hospital and patient information at all times as observed by management and peers: Will not discuss any patient information in public areas. Will not discuss any patient with friends, family who may call to ask about a child who has been here. Will only discuss other accounts with staff on a need to know basis to ensure payment of the claim or resolution of