Supv Billing

Saint Elizabeth Medical Center•Cincinnati, OH

10d

About The Position

This position is responsible for the billing portion of the Electronic Billing System (EPIC) and providing leadership for the Commercial and Government billing staff. Position is also responsible for management of the department in the absence of the Manager and Follow-up unit in the absence of the Follow-up Supervisor. Assist with system evaluation, testing, implementations, upgrades, and software changes. Perform troubleshooting, auditing, system integration(s), and coordination with Information Systems personnel (IS), Revenue Enhancement, Registration, Hospice, etc. Provides technical support and training to users as needed and assist management team with system related issues. Responsibilities include staying current on Commercial, other third party, and Government regulation. In addition, training all department staff in regards to billing functions and acting as liaison between billing/follow-up staff and other units and/or departments. Work closely with the Clearinghouse System Coordinator to achieve the most cohesive billing and clearing-house systems. Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.

Requirements

High School Graduate AND 4 years of experience OR Equivalent combination of education and Experience comparable to associate’s degree
Knowledge of regulations for Commercial, Government and other Third Party insurance
PC Window Applications
Excellent communication skills – verbal and written
3 years of related experience including: Commercial, Government and other Third Party hospital billing/ reimbursement/collection experience.

Responsibilities

Manage and coach a subordinate group
Performs employee performance evaluations and participates in Follow-up employee performance evaluations by giving the Manager and Follow-up Supervisor billing information gathered from account reviews and observations.
Develop, promote and maintain professional relationships, both internally and externally.
Train, develop and coach, counsel, assign duties and work schedules.
Evaluate job performance and review performance appraisal with personnel.
Initiate or recommend necessary counseling, disciplinary actions, termination and commendatory actions.
Communicates with supervisor/Manager and payers of any issues that would prohibit claim payment and elevate serious barriers to appropriate management.
Provide effective leadership to ensure goals of the department and the organization.
Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, managers and directors.
Assists other associates when necessary, as determined by manager, works with staff to identify and resolve issues and develop standard practices
Completes special projects & tasks by the established time frame which can include organizing workload and/or associates for successful account resolution: proactively notifies manager of any barriers that prohibit billing and/or payment of claims.
Assumes duties of manager as needed.
Assists co- worker in problem solving, with reports and work lists, meetings, etc.
Serves as a backup in the absence of staff members.
Assign, monitor / review the task progress and ensure accurate work of a group of employees.
Provide instruction so others on the team can complete tasks quickly and effectively.
Inform management of overall performance of team members
Provide technical guidance on more complex issues including but limited to maximum reimbursement.
Create and maintain Procedures for the department
Assists the Clearinghouse Systems Coordinator with the identification and resolution of Commercial and Government billing issues. This includes trending coding issues, charging issues and reconciling electronic billing issues. This position will also serve as a backup to the Systems Coordinator.
Reviews and works with the Commercial Billing Lead, PFS Lead, and Patient Finance Specialist II weekly in reconciling unbilled accounts, billing edits issues and/or associate issues.
Execute training of contracted staff (internal and external).
Maintain collaborative working relationships with HIM, clinical, financial and support departments and Third-Party Payers to coordinate and facilitate the unit activities, to accomplish goals and objectives and to resolve problems.
Manages Expected Reimbursement Medicare IME no pay accounts along with DRG readmit accounts
Submits bills to payers electronically if possible, otherwise paper
Proficient in Medicare/Government regulations and reimbursement policies
Proficient in third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
Assist Medical Records and Revenue Department on high dollar claims, changing DRG, coding, and charges on processed claims including but not limited to Consecutive Account management, Follow-up Vendor Account management and Reimbursement Account management.
Calls payers/ Patients or uses online resources to obtain status on accounts housed on work lists.
Records appropriately detailed notes in the billing system
Takes appropriate action to resolve claims, i.e., the representative will execute any and all steps to resolve unpaid claim, including but not limited to; rebill of claim.
Initiate appeals when necessary or works with Utilization Management / Risk Management for appropriate appeal process.
Calculates expected reimbursement/ Adjustments on accounts if/when necessary.
Facilities, generate spreadsheets/ invoices, track payment/nonpayment.
Establishes relationship with payer contacts
Establish Relationship with other Departments
Performs due diligence on all collection efforts
Ensures expected reimbursement is secured
Trends weekly productivity, Billing CFB, Follow-up agings
Edit WQs (Securing required data necessary for billing.)
Attends weekly billing staff meetings
Identifies payer & billing issues
Participates in a positive & constructive manner
Responds to internal and external customer calls or concerns. In the absence of management will lead meetings and other operational issues.
Seeks opportunity for training & informs manager of all training needs.
Attends Seminars and workshops as assigned by manager, to obtain billing and/or follow up information related to specific payers
Performs other duties as assigned.