Oversight of the Insurance Department including all aspects of billing, posting, collections, employee management, refunds, credentialing, verifications, pre-certifications and referrals while adhering to existing contracts, policies or regulations.
Hire, train and evaluate
Time card management including scheduling
Distribute work assignments and evaluate needs
Maintain functionality for assigned areas of responsibility (file maintenance)
Correct daily claim billing electronic claims rejections and errors
Maintain electronic billing contracts, ERA/EFT and Eligibility functionality
Review medical record requests for claim payment
Review and approve patient accounts for collections
Review and respond to written patient complaints regarding invoicing
Review and respond to credit card charge backs
Review and respond to requests for adjustments/write-offs
Review and approve/deny pay plans
Medical plan payment posting, portal billing and collections
Primary point of contact for ambulatory surgery centers; review and respond to requests
Education: Bachelor’s degree preferred, and at least 8 years of Billing and Supervisory Experience
Specialized Knowledge: Must be ICD10 proficient with an understanding of CPT and modifiers for professional, anesthesia and ambulatory surgical center services.
Medical management background consisting of Medicare, managed care and commercial insurance carriers from a billing perspective.
Skills: Leadership, computer (Word, Excel, Power-Point), excellent written and verbal communication, ability to critically respond to problems and respond accordingly to conflict or crisis.