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Hurley Medical Center · 13 hours ago

Professional Billing Supv

MI, United States

Full-time

Onsite

Senior Level

5+ years exp

Hurley Medical Center is seeking a Professional Billing Supervisor to oversee and participate in professional billing activities within Patient Billing Services. The role involves planning and implementing departmental policies, ensuring compliance with billing standards, and supervising billing personnel.

Health CareNon Profit

Responsibilities

Supervises, coordinates, and participates in regular, ongoing billing operations and activities. Reviews and processes clinic and contract physician billing

Develops, monitors, and ensures adherence to policies and procedures to accomplish agreed-upon departmental objectives and maintain efficient billing productivity standards

Develops staffing and work schedules for billing personnel. Approves leaves, vacations, personal days, and overtime. Computes and signs time cards

Evaluates and provides recommendations regarding hiring, progressive discipline, and/or discharge of subordinate employees. Monitors and evaluates work of billing personnel. Participates in performance reviews. Handles grievances at first step

Assists in orientation, training, and in-service/continuing education of physician billing personnel

Prepares and assigns work as necessary to ensure equitable bill distribution and efficient billing productivity. Assures compliance with billing productivity standards through use of daily production records

Initiates prompt follow up action on accounts already billed to third party

Maintains and controls requests for billing information from physicians and Medical Center administration. Interacts with computer service company and balances electronic charge and payment reports

Analyzes billing errors and recommends corrective action. Works closely with professional billing personnel to ensure prompt payment in all areas

Ensures efficient, effective, and increased use of electronic billing to and electric payment from third party payers

Acts as liaison between billing, medical records, service access management services, and information technology

Interacts with physicians as required to resolve third party concerns and keeps all parties informed of current billing activities

Compiles and maintains monthly department reports including management reports regarding collections, billings, productivity and performance standards. Distributes to contract physicians, Research and Education department heads and administration as appropriate

Collects information and processes applications for third party payer enrollment for initial and subsequent credentialing cycles. Maintains appropriate records, files, and logs and utilizes computer for access, input, and retrieval of pertinent information

Handles initial and follow-up inquiries regarding third party applications and enrollment

Qualification

Physician billing experienceCertified Coding SpecialistMedical terminology knowledgeMedical Center computer systemsAccounts receivable managementData analysisSpreadsheet developmentConflict resolutionEffective communicationOrganizational skills

Required

High School Diploma or GED

Five (5) years of experience in inpatient and outpatient, computerized and manual physician billing for both physician and non-physician practitioners and third party carriers utilizing a 1500 claim form and/or 1500 electronic billing procedures/methods in a professional office or multi-practice setting. An Associate degree in Business Administration, Health Care Administration, Medical Insurance Specialist or related field with at least eight (8) semester or twelve (12) quarter credits in Accounting may substitute for two (2) years of the required experience. A Bachelor's degree in Business Administration, Health Care Administration, Medical Insurance Specialist with at least eleven (11) semester or sixteen (16) quarter credits in accounting may be substituted for three (3) years of the required experience

Incumbents appointed to this classification must be certified by the American Health Information Management Association or the American Association of Physician Coders as a Certified Coding Specialist-Physician Based (CCS-P) and/or Certified Professional Coder (CPC) within six (6) months of date of appointment. Failure to obtain and maintain required certification shall be grounds for termination

Demonstrated knowledge in medical terminology, anatomy, physiology, and coding classification systems (ICD-9-CM, CPT, HCPCS)

Demonstrated knowledge of Medical Center computer systems (e.g., Advantae, SMS, MRIS, Medifax/HDX, DENIS, PHO referral)

Knowledge of inpatient and outpatient professional billing regulatory requirements for third party carriers

Knowledge of documentation requirements for professional billing

Knowledge of fee for service and capitation payment methodologies and CCI edits

Knowledge of accounts receivable control and general credit policy

Demonstrated ability to problem solve and to use conflict resolution techniques

Ability to understand and analyze accounts receivable management-related reports

Ability to analyze and interpret data

Ability to develop electronic spreadsheets

Ability to organize and coordinate daily assignments independently

Ability to communicate both orally and in writing

Ability to establish and maintain effective working relations with administration, department heads, co-workers, subordinates, physicians, other Medical Center employees, patients, and the general public