Summary of Duties and Responsibilities:
Responsible for managing all Billing & A/R staff in which process runs for reimbursement by Medicare, Medicaid, primary insurance, supplemental insurance companies and private pay accounts.
Major areas of Responsibility:
- Supervision of support billing and A/R staff. Hire, train and supervise personnel to assure efficient workflow in the department. Approves PTO requests, maintains calendar of scheduled absences, takes phone calls from staff regarding absences due to illness and determines changes in staffing levels between sites to best meet overall daily needs. Trouble shoot day to day staff/work related issues.
- Supervises automated accounts receivable and billing system. Ensures that departmental staff completes Medicare, Medicaid, primary insurance, supplemental insurance and individual billing forms or statements following appropriate regulations and guidelines. Files electronic claims when/as eligible.
- Contacts patients, relatives, physicians, physician office staff, hospitals, paramedics and other parties either by telephone or correspondence, to secure required information as needed by support staff.
- Contacts insurance companies, attorneys, patients, or any other source as required for follow-up claim payment status when needed by support staff.
- Monitors newsletter, manual updates, handbooks and other directives for Medicare, Medicaid and other insurance companies updates and current required procedures or changes for compliance in processing claims.
- Perform any other related duties as required or assigned.
- Managers are to be confident that functions under their responsibility are being properly managed; effective; in compliance with all Federal and State Laws and regulatory agency and free from ethical lapses, waste, fraud, abuse, and threats to health and safety to the best of their ability. This includes the organization’s efforts to prevent and/or mitigate loss, risk to or from personnel, threats to its physical assets, damage to its technology and intellectual property, and risks arising from all elements surrounding the work environment. All members of management are to report systematically and promptly to senior management or directly to the Compliance Officer, any perceived new risks or failure of existing control measures.
- Ensure effective management of the organization’s performance in such areas as community affairs, human rights, employment practices, health and safety and the environment.
Education, Work Experience and Specialized Skills/Knowledge:
- High school diploma or GED, plus 2 years of related experience and/or on the job training. Or equivalent combination of education and experience.
- Ability to effectively communicate information and respond to questions in person-to-person and small group situations with customers, clients, general public and other employees of the organization.
- Ability to add, subtract, multiply, and divide in all units of measure. Must be able to know intermediate accounting.
- Software skills are required: such as alphanumeric data entry, database, spreadsheets, word processing/typing, and 10-key.
While performing the functions of this job, the employee is regularly required to sit, talk or hear; frequently required to use hands to finger, handle, or feel; and occasionally required to stand, walk, reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision; and color vision.