Supervisor - Professional Billing Services

FLSA Status

Job Role Summary

Essential Functions and Responsibilities

• Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County; models Eskenazi Health values
• Assigns and monitors workflow as directed by management to ensure timely and accurate submission of claims for payment
• Responsible for the supervision and work assignments for Professional Billing
• Works with management to develop and maintain employee training assessments, departmental manuals/departmental handbook, policy and procedure workflows; works with management providing input on probationary and annual employee evaluations of all assigned personnel
• Responsible for the training and instruction of new team members and current team members as new policies or requirements arise
• Works with management to enforce all assigned team disciplinary actions as needed in accordance with labor contracts and hospital and/or departmental policy/procedures
• Coordinates the daily operations for all professional billing and reimbursement to ensure appropriate cash flow is maintained, and that patient satisfaction with administrative functions at Eskenazi Health, Eskenazi Medical Group and Eskenazi Health Centers are consistently positive; works closely with other areas within Eskenazi Health, Eskenazi Medical Group and Eskenazi Health Centers to ensure compliant and optimal collection of professional services revenue
• Coordinates and monitors activities relative to patients' accounts and services required/rendered to ensure that billing documents and reports are complete and accurate, and are in compliance with Eskenazi Health's Privacy and Security policies and practices
• Ensures timely billing and/or follow-up/monitoring of all accounts to ensure timeframes are maintained according to Eskenazi Health policy, federal statute, state statute, and claim filing timelines for other third party payers
• Contributes to completion of various financial forecasts, including daily dashboard monitoring, month-end reporting, including but not limited to, Claim inventory, Accounts Receivables inventory and aging reporting and the performance statistics for all assigned personnel
• Reviews and approves adjustment and/or contractual write-offs for assigned personnel up to approved level
• Ensures that productivity and quality standards are met, meeting with staff biweekly; maintains a file for all assigned personnel to ensure successful billing and/or collection of assigned accounts
• Troubleshoots issues and anticipates potential problems, involving management for resolution
• Participates in and makes recommendations during the interview/hiring process of new employees
• Keeps up to date on account billing/collection rules and regulations; and contracts terms and conditions with regard to timely filings; service pre-certifications, and authorizations; informs Manager of issues, concerns or problems impeding account collection efforts and assists in resolving
• Assists Management with any overall strategic plans, goals or objectives for the department
• Handles difficult or problem patient account cases and takes calls from the customer services lines when needed
• Responds to emails and voicemails daily, serving as a resource to other departments concerning patient billing and claims
• Responsible for any assigned special project
• Cooperates with other departments to resolve problems and expedite billing/collection processes
• Insures completion of annual competencies for all staff
• Responsible for ensuring all compliance, HIPAA and other regulatory agencies (as designated by Eskenazi Health) annual in-services are completed and employees are tested as required
• Attends meetings and in-service offerings

Job Requirements

• Associate's or Bachelor's degree in business-related field preferred
• 5 years of experience in patient accounts receivables, billing, credit and collections or a combination of these with supervisory experience
• Dental, vision, DME and/or FQHC billing a plus
• Epic experience a plus
• CPC certification preferred
• Previous management or supervisory experience preferred, with demonstrated critical thinking, analytical and problem-solving ability
• Requires basic knowledge of ICD-10 CD, medical terminology, CPT and HCPCS Codes, diagnostic and therapeutic tests, medical record documentation retrieval, and reimbursement methodologies
• Extensive knowledge of CCI, medical policy and billing requirements for governmental and commercial payors
• Knowledge of reimbursement procedures, provider coverage, complex State/Federal regulations/policies, compliance and HIPAA guidelines; Eskenazi Health's procedures/policies; basic accounting/bookkeeping principles methods; Epic, MedAssets, Claim Remiedi editing systems
• Requires excellent communication skills (written, oral & presentation), interpersonal skills, a high level of organization and the ability to mentor others
• High level of professionalism and ethical behavior; detail-oriented with numeric aptitude
• Extensive knowledge of reimbursement guidelines and principles for all major third party and governmental payers - Medicare, Medicaid, Blue Cross, Commercial and Special Payers, HMO's, Workman's Compensation and No Fault coverage
• Ability to motivate staff in achieving departmental goals while maintaining positive internal and external customer relationships
• Ability to work independently and exercise professional judgment to meet daily operational demands
• Ability to work effectively under pressure and accept responsibility for decisions
• Experience working in Microsoft Office suite applications including Excel, Word, and Power Point
• Professional, team-oriented, solution-driven approach to problem solving for all types of issues

Knowledge, Skills & Abilities

TBD