Responsible for day-to-day operations in the PFS/Patient Accounts Department, specifically with respect to the supervision of staff responsible for timely and accurate institutional and professional billing and follow-up for third party payers (governmental and non-governmental). Responsible for ensuring compliance with all organizational, statutory, and federal, contractual obligations, regulations and standards. Serves as super user for billing system, ePremis, including but not limited to maintaining edits, bridge routines, and establishing and maintaining billing system vendor and IT relationships. Maintain a working knowledge of all applicable systems (i.e. Star, Epremis, Accupost, QMS, Code Correct, etc.)
Experience with ePremis billing software is a plus. Must have an excellent working knowledge of ICD-9, CPT, and HCPCS coding classification systems and medical terminology. CPC or completed within 6 months.
The candidate must have knowledge of Microsoft applications. Must be organized and detail-oriented. Excellent verbal and written communication skills are a must.
This position provides leadership and oversight for the Billing and Follow-up staff. This position requires complex data analysis and troubleshooting, and is required to make independent decisions within the scope of responsibility.
Minimum 2 years college education B.S. in Business, Finance, Accounting or Computer Science strongly preferred or equivalent experience.
CPC certification or within 6 months of employment.
Three years Supervisor/Managerial experience in a Patient Accounts setting required. Minimum two years experience in government third party billing regulations, including but not limited to certifications, authorizations, insurance assignments, coordination of benefits and compliance. Third party billing knowledge/experience, specific to federal and state regulations and/or managed care, required.
Personal Computer, phone, adding machine, fax, copier and printer experience required.
Basic knowledge of standard Office software including document, spreadsheet and database applications.
Basic knowledge of self-pay collections, financial assessments, liability claims, lien and bankruptcy filing practices.
Excellent written and verbal communication skills.
Excellent organizational skills.
Specific skills, knowledge and abilities include:
•Knowledge of state and federal regulations as they pertain to billing processes, procedures and reimbursement
•Knowledge of insurance rules and regulations
•Knowledge of insurance claim processing, claims editing, and third party reimbursement
•Knowledge and detailed understanding of ICD-9, CPT, and HCPCS coding classification systems and medical terminology
•Knowledge of customer service center environments, technology and processes
•Skill in good oral, written, and interpersonal communication, including preparation and delivery of formal large group presentations (employer, customer, association and payer groups); skill in report writing and business correspondence.
•Ability to read, analyze, and interpret documents such as general business periodicals, journals, financial reports, government regulations, and procedure manuals
•Ability to develop a strong team environment, with clear roles and responsibilities, teamwork, and team development; applies appropriate supervisory, management and leadership techniques in an operations setting
Southern Regional Health - 2 years ago