Supervisor, Medical Billing/Coding Specialist

Medical Billing/Coding/Collections Supervisor

Job Description

General Description: 

Responsible for all aspects of revenue cycle including registration, charge posting, billing, payment posting, collections, & claim appeals.  The Medical Billing/Coding/Collections Supervisor is responsible for the timely follow through and follow-up on claims and patient balances through acceptable resolution.   Medical Billing/Coding/Collections Supervisor possesses extensive experience optimizing revenue outcomes through clean claims submission and master level skills appealing denied or underpaid claims.   

Medical Billing/Coding/Collections Supervisor is the lead person responsible for the Accounts Receivable.

Medical Billing/Coding & Collections Supervisor is a master level user of eCW and is responsible for the system set up and maintenance of master files pertaining to Revenue Cycle.  Medical Billing/Coding Collections Supervisor is liaison and responsible for vendor set up, testing, and maintenance of the Revenue Cycle.  The Medical Billing/Coding/Collections Supervisor is highly organized; works collaboratively with other revenue cycle team members acting in a team lead role.

Reports to:         Practice Manager

Provide Leadership with Ultimate Responsibility:

·         Timely review of failed edits for correction of patient registration or patient demographic changes.

·         Review charges from physician’s operative notes or office charge ticket.  Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD-9 code, date of admission, and date of injury (DOI).  Asks for clarification from provider as needed.

·         Understand and interpret the Correct Coding Initiative (CCI) as it applies to charge entry work.

·         Through understanding of payer medical policies for Bariatric surgery and other surgical procedures.

·         Reduce denials by correct use of modifiers, mapping, and linking codes with services.

·         Responsible for the processing and discrepancy reconciliation and closing of charge and payment batches.

·         Ability to successfully track and follow up on information requests from patients or payers.

·         Responsible for ensuring all payments collected either prepayment or time of service are posted as corresponding charges are posted.

·         Responsible for posting all patient discounts as indicated in proposals or approved by Dr. Fenner.

·         Responsible for the timely correction of any failed claim(s) with in billing system, at clearing house, or via payer correspondence &/or EOB denial.

·         Strong customer service skills; answers patient and insurance calls; promptly returns or follows up to all interactions; prompt response to all request for information, both internal and external.

·         Post insurance payments and contractual adjustments received by mail or via clearing house payment files. 

·         Ability to conduct a contract rate audit and appeal underpaid.

·         Notify Office Manager of any payments received at 100% of charge amount.

·         Follow balancing procedures; daily and monthly.

·         Balance all payments to checks or electronic fund transfers received.

·         Bill Secondary Insurance or Patient after insurance claim processes.

·         Track all services to make certain all charges have been received and posted.  Notify provider(s) if charge ticket(s) have not been received.

·         Appeal claims timely and accurately to maximize reimbursement.

·         Work in cooperation with Patient Financial Counselor and Office Manager to manage all patient responsibility balances by preparing and sending monthly statements.

·         Work in cooperation with Patient Financial Counselor and Office Manager monitor patient aging by contacting patients with large balances to set up payment plan.

·         Prepare accounts with past due patient balances and transfer to collection agency.

·         Participate in educational opportunities to remain current on payer changes and industry updates.

·         Through understanding of CMS rules and compliance regulations.

·         Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.

·         Knowledgeable of medical EOB’s, patient deductibles and co pays, and insurance or third party correspondence.

·         Set up of all Revenue Cycle Master files in eCW

·         Set up and maintenance of all Revenue Cycle vendor and payor websites or interfaces

·         Other duties as assigned.

Skills/Experience:

·         College degree preferred

·         7-10 years Medical Billing Experience, prefer Surgical background

·         Advanced eClinical knowledge and experience a requirement

·         Knowledge and experience of medical billing/collection industry best practices

·         Extensive experience optimizing revenue outcomes through clean claims submission  

·         Master level skills appealing denied or underpaid claims

·         Highly motivated, self-directed, and attentive to detail

·         Strong organizational skills

·         Extensive knowledge on use of email, search engine, Internet; ability to effectively use payer websites

·         Knowledge of Electronic Medical Records and billing software

·         Knowledge of business office standard procedures

·         Knowledge of medical coding and billing procedures

·         Ability to read, understands, and follow oral or written instructions

·         Ability to establish and maintain effective working relations with patients, employees, cowokers

Busy surgical office