Billing and Collections Supervisor

Planned Parenthood of the Pacific Southwest•San Diego, CA

1d•$34 - $37

About The Position

Planned Parenthood of the Pacific Southwest is one of the largest providers of sexual and reproductive healthcare in Southern California, operating 20 health centers throughout our three-county region. Check out our new video, "We are Planned Parenthood of the Pacific Southwestâ for more information about our organization: https://bit.ly/WeArePPPSW. Care. No Matter What. Weâre seeking a skilled Billing & Collections Supervisor to lead and support our Medical Billing & Collections team. In this role, you will provide handsâon supervision, coaching, and performance development while ensuring accurate and timely billing of medical services. The Supervisor will oversee claim submission and followâup, partner with insurance companies on unpaid amounts, and monitor trends in rejections, denials, and outstanding claims, escalating issues to leadership as needed. This position also plays a key role in communicating with patients and staff to clarify insurance benefits, eligibility, payment options, and patient financial responsibility. If you have strong medical billing expertise and a passion for team leadership and process improvement, weâd love to have you join us.

Requirements

Bachelorâs degree or equivalent experience.
4+ years of experience in patient, third party, government, and physician billing and collections, and
1â2 years of supervisory experience and a track record of effectively overseeing daily staff production activities, and
Effectively manage multiple priorities in a fast-paced, dynamic environment.
Touch 10âkey proficiency and advanced understanding of PPO, HMO, IPA, MSO, and MediâCal billing practices.
Advanced ability to read EOBâs and interpret carrier reimbursement.
Knowledge of CPT & ICD codes. Knowledge of multiple carrier coding requirements.

Responsibilities

Responsible for the supervision, development, and evaluation of Biller/Collectors.
Work as liaison between Billing & Collections Manager & Billers.
Manages daily workflow of Billers in order to effectively and efficiently meet quality metrics.
Ensure appropriate staffing levels and make adjustments as needed.
Responsible for employee productivity and work quality. Reassign tasks as needed.
Manage breaks and meal periods for Billing & Collections staff to ensure phone coverage and compliance with agency policies.
Coaches staff when quality and productivity are not being met.
Assists staff with rapid performance improvement on quality and productivity goals.
Meets with staff that need assistance 1:1 weekly or bi-weekly as needed and agreed upon by Billing & Collections Manager.
Creates and maintains written Policies & Procedures to support department workflow.
Assists Billing & Collections Manager monitoring patient, third party, government, physician billing, aging and collections activities.
Provides guidance on coordinated processes, procedures and systems, customer service delivery models and ensuring compliance with internal policy and external agency regulations.
Stays abreast of the full array of third-party contracts and billing/collections requirements.
Provides weekly and monthly reports to the Billing & Collections Manager on staff quality and productivity. Demonstrate a higher level of proficiency in the Agencyâs Practice Management System including the ability to be a resource for other staff regarding: basic trouble shooting, error trending, root cause analysis, triaging technical problems and utilizing IT resources as needed.
Meet or exceed production goals, standards and quality set by RCM Leadership.
Consistently act as role model in attitude, productivity and customer service in the Billing & Collections Department.
Participates in educational activities and attends monthly staff meetings.
In support of PPPSWâs Just Culture Philosophy, identify and report errors, near misses, and employee, patient and customer safety concerns in a timely manner.
To support risk and quality management by proactively communicating identified risks to manager in order to minimize risk when possible.
Comply with PPPSWs Code of Conduct and maintain the highest level of professional and ethical standards and to act in compliance with both the letter and spirit of all applicable laws and regulations.
Fills in for Billing & Collections Manager as needed.
Prepare and submit clean claims to third party payers, either electronically or on paper; work claim rejections.
Verify Insurance eligibility, benefits and patient cost shares.
Perform post visit financial counselling with patients to ensure they are aware of their insurance coverage and financial responsibility. Explain complex insurance topics such as benefit coverages, copays, deductibles and coinsurance.
Negotiate payment plans for patients who cannot afford to pay cost of services in full.
Serves as a patient advocate ensuring they are aware and take advantage of programs such as Medi-Cal, FamilyPact and available sliding fee discounts.
Analyze and process third party payments/adjustments.
Determine the appropriateness of appealing denied claims, and take necessary actions to resubmit those claims on a timely basis.
Work aging and rebill reports; perform effective follow-up on unpaid claims using EPM tasking.
Update EPM system with notes from conversations with patients, payers, Contact Center or Health. Center Staff. Ensure new or pertinent demographic information from patients is updated to ensure clean claim submission to 3rd party payers.
Answer questions from patients, internal customers and insurance companies. Provide counseling to patients and health center staff on complicated insurance questions.
Identifies and resolves patient billing complaints.
Perform various collection efforts including contacting patients by phone.