Professional Billing Supervisor

FirstHealth of the Carolinas

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Job description

Overview
We are seeking a dedicated and experienced professional to direct and coordinate the accounts receivable responsibilities of the Professional (PB) claims follow-up team for the organization . In this role, you will have the opportunity to design, plan, and implement cutting-edge technology and processes to elevate our Revenue Cycle Management operations. As a key player, you will assist in resolving complex accounts receivable issues and be an integral member of the RCM team.
If you have a passion for continuous improvement and possess strong leadership skills, this is the position for you!
Responsibilities
• Direct and coordinate the follow-up and balance resolution efforts for outstanding accounts receivable under area of responsibility.
• Design, plan, and implement new technology and processes to improve professional claims follow-up and denials operations.
• Supervise personnel directly responsible for resolving outstanding professional claims.
• Assist employees in resolving outstanding claims issues, to prevent and/or work denials and allow for expected reimbursement.
• Review A/R reports and coordinate productivity of appropriate personnel to resolve outstanding claims and reduce denials.
• Actively participate in the implementation and maintenance of claim systems and claim editing processes, as well as collaborating with IT/EPIC and Coding resources on system and operational enhancements.
• Work collaboratively with other departments to share data and create effective workflow to positively impact AR management.
• Review payor websites for bulletins, transmittals, program memorandums, payor specific medical review policies, and other billing and reimbursement information.
• Educate and distribute relevant information to appropriate staff.
• Collaborate with other RCM leaders to improve operational flow and employee satisfaction.
• Work with management to solve problems, enhance productivity, and handle special situations.
• Assist with patient inquiries related to claims/billing issues, working with our Customer Service Department for patient communications and resolutions.
• Assist other departments with billing problems.
• Assist with new system upgrades, changes, and testing.

Qualifications
• High School graduate plus two years' additional education in accounting or business administration, or equivalent work experience.
• Minimum of five years' experience in similar healthcare Revenue Cycle Management role, preferred.
• Strong interpersonal and verbal communication skills.
• Ability to manage multiple tasks in an organized manner.
• Excellent analytical and problem-solving skills.
• Leadership skills with the ability to reach consensus.
• Demonstrated strong computer skills. EPIC experience, preferred.
• Knowledge of CPT-4, HCPCs, UB-04, and ICD-10 Coding, as well as various payor guidelines and requirements.
• Ability to work independently, exercising sound judgment, discretion, and initiative.

Join our team and make a meaningful impact on our Revenue Cycle
• Direct and coordinate the follow-up and balance resolution efforts for outstanding accounts receivable under area of responsibility.
• Design, plan, and implement new technology and processes to improve professional claims follow-up and denials operations.
• Supervise personnel directly responsible for resolving outstanding professional claims.
• Assist employees in resolving outstanding claims issues, to prevent and/or work denials and allow for expected reimbursement.
• Review A/R reports and coordinate productivity of appropriate personnel to resolve outstanding claims and reduce denials.
• Actively participate in the implementation and maintenance of claim systems and claim editing processes, as well as collaborating with IT/EPIC and Coding resources on system and operational enhancements.
• Work collaboratively with other departments to share data and create effective workflow to positively impact AR management.
• Review payor websites for bulletins, transmittals, program memorandums, payor specific medical review policies, and other billing and reimbursement information.
• Educate and distribute relevant information to appropriate staff.
• Collaborate with other RCM leaders to improve operational flow and employee satisfaction.
• Work with management to solve problems, enhance productivity, and handle special situations.
• Assist with patient inquiries related to claims/billing issues, working with our Customer Service Department for patient communications and resolutions.
• Assist other departments with billing problems.
• Assist with new system upgrades, changes, and testing.
• High School graduate plus two years' additional education in accounting or business administration, or equivalent work experience.
• Minimum of five years' experience in similar healthcare Revenue Cycle Management role, preferred.
• Strong interpersonal and verbal communication skills.
• Ability to manage multiple tasks in an organized manner.
• Excellent analytical and problem-solving skills.
• Leadership skills with the ability to reach consensus.
• Demonstrated strong computer skills. EPIC experience, preferred.
• Knowledge of CPT-4, HCPCs, UB-04, and ICD-10 Coding, as well as various payor guidelines and requirements.
• Ability to work independently, exercising sound judgment, discretion, and initiative.

Join our team and make a meaningful impact on our Revenue Cycle

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