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Performs all functions necessary to accomplish accurate billing and follow-up/collections of patient hospital accounts. Works as a back-up biller and/or collector when needed. Responsible for training all new billers/collectors. Works proficient with other departments resolving issues. Ensures systems and procedures are in place to maximize reimbursement from patients and all third-party payers. Prepares statistical and analytical reports for management review.
Job Responsibility:
Maintains consistency with Administrative and Departmental policies with appropriate behavior, dress, attitude, attendance, confidentiality, professionalism, and reliability
Ensures all accounts are processed for billing and follow-up activity
Supervises the day-to-day work effort for billing and follow-up functions ensuring that established productivity and quality goals are achieved
Maintains knowledge of all billing systems, and assist as necessary to troubleshoot issues with clearinghouse and payers
Ensures the 72 hour and combined billing reports for insurance payers are worked daily
Keeps abreast of all regulatory changes and communicates these to management, billing, and follow-up staff in a timely and effective manner
Must have monthly meetings (or more as needed) with associates to review changes and/or new guidelines
Monitors billing, follow-up/collections, and payment validation workflow, directs work task as necessary to manage fluctuation volumes
Ensures managed care payments are paid according to managed care contracts and appeals are done for any underpayments
Ensures overpayments are refunded to payer accordingly
Provides feedback to Director regarding staff performance productivity and teamwork capabilities
Analyzes, trends, reports and makes recommendations on billing issues, claim rejections and issues affecting timely follow-up and collections of accounts
Requirements:
High school diploma or equivalent
0 – 2 years of supervisory/management experience preferred
4 years of experience in similar or related role preferred