Billing Department Supervisor

Castle Family Health Centers•Atwater, CA

21h

About The Position

Position is responsible for managing the daily processing of medical charges, filing insurance claims and collection accounts. Applicant must have 3 to 5 years of managerial experience with knowledge and understanding of FQHC medical billing and/or coding systems. Knowledge of Federal, State and Private Insurance regulations regarding medical billing and extensive billing compliance. Experience and/or knowledge of computerized information systems specifically with the NextGen medical billing system preferred. Knowledge of federal, State and Private Insurance credentialing procedures preferred. Overtime may be required. Responsible for management of the day-to-day operations of the Accounts Receivable Department ensuring adherence to policies and procedures. Oversees the hiring and supervision of personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions, including termination; motivates employees to achieve peak productivity and performance. Works with billing staff to establish departmental goals and timelines and update Supervisor monthly on whether the goals have been met. Informs CFO as soon as possible if there are barriers to meeting goals. Develops or assists CFO with the development and implementation of policies and procedures to ensure efficient and safe operation of the department and to meet established goals and timelines. Works with the CFO and other staff in the planning, implementation and evaluation of modifications to existing operations, systems and procedures, especially those related to reimbursement maximization and accounts receivable. Monitors accounts receivable. Responds as needed to accounts receivable problems. Maintains the tables and information in the practice management system that supports patient and insurance billing. Keeps current on updates to the practice management software and communicates changes to staff. As needed, works with practice management software vendor and clearinghouse to solve billing problems. Oversees clinic's collection programs. Monitors and evaluates program effectiveness and progress and works with Supervisor on improvements and changes. Coordinates with Supervisor on needed training for providers for maximizing reimbursement. Handles patient complaints about fees and billing and decides upon the disposition of these complaints. Handles complaints and quality requirements relating to billing department function from insurance carriers and other 3rd party payers and decides upon resolution strategies for these complaints. Works as liaison with other departments to facilitate problem solving and data collection appropriate to patient and insurance billing. Ensures that all billing and collection activities meet and adhere to Medicare, Medi-cal and other insurance regulations, rules, and laws. Participates in performance improvement projects as assigned. Participates in meetings and committees as assigned. Attends and participates in staff meetings and required education programs. Attends and participates in management team meetings. Follows all CFHC and departmental policies and procedures. Adheres to all applicable laws and regulations. Maintains confidentiality within the workplace and within the community. Demonstrates commitment and alignment to Castle's mission and vision. High degree of confidentiality, integrity and professionalism. Handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Ensure patient and/or insurance refunds are done in a timely manner in accordance with state and /or federal requirements. Ensure that a good audit trail and records are maintained. Verify and update health care changes against established rates for diagnosis, treatment services and supplies, maintains patient accounts via an automated billing system, using standard industry codes to facilitate reimbursement from governmental and commercial insurances, and established pro-rata responsibility to permit prompt collection of patient share. Perform other job duties as assigned by supervisor.

Requirements

Applicant must have 3 to 5 years of managerial experience with knowledge and understanding of FQHC medical billing and/or coding systems.
Knowledge of Federal, State and Private Insurance regulations regarding medical billing and extensive billing compliance.
Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.
Ability to use independent judgment and to manage and impart confidential information.
Knowledge and understanding of medical billing and/or coding systems, as appropriate to the position.
Knowledge of Federal, State, and Private Insurance regulations regarding medical billing compliance.
Ability to effectively communicate information, policies, and/or procedures in a manner easily understood manner.
Ability to correspond with all departments to communicate current and e new changes or situations that may effect the cash flow for the corporation.
Ability to schedule and conduct training and seminars on billing policies and procedures (tapes, seminars, reading, and/or hands on).
Hold a minimum of one office meeting monthly.
Review and trace claims over 45 days old with staff and establishes policies on how to appropriately handle these claims.
Ability to develop, plan, and implement short-and long-range goals.
Ability to foster a cooperative work environment and create a team working environment.
Employee development and performance management skills.
Skill in the use of computers.
Ability to communicate effectively, both orally and in writing.
Ability to effectively communication in English verbal and writing.
BA Degree, and/or four to five years related experience and/or training; or equivalent combination of education and experience .
Ability to read and comprehend simple instructions, short correspondence, and memos.
Ability to write simple correspondence.
Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
Ability to deal with problems involving a few concrete variables in standardized situations.

Nice To Haves

Experience and/or knowledge of computerized information systems specifically with the NextGen medical billing system preferred.
Knowledge of federal, State and Private Insurance credentialing procedures preferred.
Coding Certificate preferred.
Bilingual English/Spanish both verbal and written a plus.

Responsibilities

Responsible for management of the day-to-day operations of the Accounts Receivable Department ensuring adherence to policies and procedures.
Oversees the hiring and supervision of personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions, including termination; motivates employees to achieve peak productivity and performance.
Works with billing staff to establish departmental goals and timelines and update Supervisor monthly on whether the goals have been met.
Informs CFO as soon as possible if there are barriers to meeting goals.
Develops or assists CFO with the development and implementation of policies and procedures to ensure efficient and safe operation of the department and to meet established goals and timelines.
Works with the CFO and other staff in the planning, implementation and evaluation of modifications to existing operations, systems and procedures, especially those related to reimbursement maximization and accounts receivable.
Monitors accounts receivable.
Responds as needed to accounts receivable problems.
Maintains the tables and information in the practice management system that supports patient and insurance billing.
Keeps current on updates to the practice management software and communicates changes to staff.
As needed, works with practice management software vendor and clearinghouse to solve billing problems.
Oversees clinic's collection programs.
Monitors and evaluates program effectiveness and progress and works with Supervisor on improvements and changes.
Coordinates with Supervisor on needed training for providers for maximizing reimbursement.
Handles patient complaints about fees and billing and decides upon the disposition of these complaints.
Handles complaints and quality requirements relating to billing department function from insurance carriers and other 3rd party payers and decides upon resolution strategies for these complaints.
Works as liaison with other departments to facilitate problem solving and data collection appropriate to patient and insurance billing.
Ensures that all billing and collection activities meet and adhere to Medicare, Medi-cal and other insurance regulations, rules, and laws.
Participates in performance improvement projects as assigned.
Participates in meetings and committees as assigned.
Attends and participates in staff meetings and required education programs.
Attends and participates in management team meetings.
Follows all CFHC and departmental policies and procedures.
Adheres to all applicable laws and regulations.
Maintains confidentiality within the workplace and within the community.
Demonstrates commitment and alignment to Castle's mission and vision.
High degree of confidentiality, integrity and professionalism.
Handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Ensure patient and/or insurance refunds are done in a timely manner in accordance with state and /or federal requirements.
Ensure that a good audit trail and records are maintained.
Verify and update health care changes against established rates for diagnosis, treatment services and supplies, maintains patient accounts via an automated billing system, using standard industry codes to facilitate reimbursement from governmental and commercial insurances, and established pro-rata responsibility to permit prompt collection of patient share.
Perform other job duties as assigned by supervisor.