Professional Billing Supervisor

FirstHealth of the Carolinas, Inc.•Southern Pines, NC

About The Position

We are seeking a dedicated and experienced professional to direct and coordinate the accounts receivable responsibilities of the Professional (PB) claims follow-up team for the organization . In this role, you will have the opportunity to design, plan, and implement cutting-edge technology and processes to elevate our Revenue Cycle Management operations. As a key player, you will assist in resolving complex accounts receivable issues and be an integral member of the RCM team. If you have a passion for continuous improvement and possess strong leadership skills, this is the position for you!

Requirements

High School graduate plus two years' additional education in accounting or business administration, or equivalent work experience.
Minimum of five years' experience in similar healthcare Revenue Cycle Management role, preferred.
Strong interpersonal and verbal communication skills.
Ability to manage multiple tasks in an organized manner.
Excellent analytical and problem-solving skills.
Leadership skills with the ability to reach consensus.
Demonstrated strong computer skills.
Knowledge of CPT-4, HCPCs, UB-04, and ICD-10 Coding, as well as various payor guidelines and requirements.
Ability to work independently, exercising sound judgment, discretion, and initiative.

Nice To Haves

EPIC experience, preferred.

Responsibilities

Direct and coordinate the follow-up and balance resolution efforts for outstanding accounts receivable under area of responsibility.
Design, plan, and implement new technology and processes to improve professional claims follow-up and denials operations.
Supervise personnel directly responsible for resolving outstanding professional claims.
Assist employees in resolving outstanding claims issues, to prevent and/or work denials and allow for expected reimbursement.
Review A/R reports and coordinate productivity of appropriate personnel to resolve outstanding claims and reduce denials.
Actively participate in the implementation and maintenance of claim systems and claim editing processes, as well as collaborating with IT/EPIC and Coding resources on system and operational enhancements.
Work collaboratively with other departments to share data and create effective workflow to positively impact AR management.
Review payor websites for bulletins, transmittals, program memorandums, payor specific medical review policies, and other billing and reimbursement information.
Educate and distribute relevant information to appropriate staff.
Collaborate with other RCM leaders to improve operational flow and employee satisfaction.
Work with management to solve problems, enhance productivity, and handle special situations.
Assist with patient inquiries related to claims/billing issues, working with our Customer Service Department for patient communications and resolutions.
Assist other departments with billing problems.
Assist with new system upgrades, changes, and testing.