Responsible for supervising all the staff responsible for the billing and follow-up functions for assigned third party payers of DCH Regional Health System. Ensures billing insurance claims meet third party payer requirements and are billed timely. Reviews and monitors productivity standards for all positions to ensure the Insurance AR is resolved and collected. Required to maintain departmental goals for AR Aging, AR Days, and Cash Collections and other benchmarks related to the revenue Cycle.
KEY RESPONSIBILITIES / ESSENTIAL FUNCTIONS
- Supervises the day-to-day functions of the insurance billing and follow team to ensure optimal efficiency and accuracy for all insurance third-party claims.
- Monitors reports and tasks of billing and follow-up teams to ensure a positive cash flow.
- Prepares and submits reports to management monthly and upon request.
- The following supervisory duties and responsibilities:
- Monitors time and attendance of staff
- Assists with performance evaluations of staff
- Recruits, orients, and ensures staff is trained to meet the expected job performance
- Audits and provides direct coaching to staff regarding their job performance
- Accountable for productivity to meet departmental goals for AR: AR aging, AR Days, Cash Collections, etc
- Responds to staff, insurance companies, and patients to resolve concerns in a timely manner.
- Knowledgeable on all insurance contracts and billing requirements.
- Monitors and evaluates departmental goals and works with Patient Accounts Manager to revise goals as needed
- Communicates and works with other DCH System departments/facilities to improve processes and procedures to ensure compliant billing with all federal, state, DCH, and departmental regulations
- All other duties as assigned.
- Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
- Performs compliance requirements as outlined in the Employee Handbook
- Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
- Requires use of electronic mail, time and attendance software, learning management software and intranet.
- Must adhere to all DCH Health System policies and procedures.
- All other duties as assigned.
MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE REQUIRED
High School diploma or equivalent is required. Bachelor’s degree in a Business related field is required OR a minimum of three (3) years of related experience in a healthcare related business office is required with extensive knowledge of billing and follow-up with insurances, governmental (Medicare and Medicaid, HMO, PPO, Commercial, etc. is required. Prior supervisory experience is required. Knowledge and participation in process-improvement initiatives using programs such as LEAN and/or Six Sigma preferred. Proficient in personal computer skills and interpersonal/communication skills, and customer service skills.
Must be able to read, write legibly, speak, and comprehend English.
Working indoors in a cubical area, sitting 80% of the time, standing 5%, kneeling 2.5%, squatting/crouching 2.5%, stooping 5%, and walking 5%. Activities include lifting of 35 lbs. maximum which would be a two (2) person lift, frequent lifting and/or carrying 20 lbs. Ability to push or pull over carpet floors, concrete ramps and on varied surfaces, a four wheel cart with 50 lb. of paperwork.
Filing ledgers or finding ledgers requires reaching, pushing, pulling, and extending the hands and arms in any direction. Stooping and bending the body forward by bending the spine at the waist. To reach lower areas requires kneeling by bending the legs at the knee or crouching by bending the body downward and/or forward by bending the legs and spine. This is 50% of daily work.
Organizing charts requires handling of papers by holding, grasping and turning, with picking up and pinching as finger movements. This is a repetitious procedure that is constantly being done.
Communication through talking, expressing or exchanging ideas by means of the spoken word. Hearing; perceiving the nature of sounds of the ear in order to communicate. Seeing; use of vision to determine characteristics of objects, depth perception, color vision with the ability to distinguish color, coding ledgers, near/far activity of 100% daily.
Mental Capability to maintain patient confidentiality 100% of the time.
Physical presence onsite is essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.