Professional Billing Supervisor

FirstHealth of the Carolinas, Inc.

Southern Pines, North Carolina

JOB DETAILS
LOCATION
Southern Pines, North Carolina
POSTED
10 days ago
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

About the Company

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FirstHealth of the Carolinas, Inc.