Medical Billing Supervisor Job in Riverside 92501, California US

Medical Billing Supervisor

Job Description

 

The fundamental reason this position is to manage and supervise billing and collection activities for all group accounts. This includes, but not limited to Medi-Cal, Medicare, Commercial Insurance (i.e.: Blue Cross-Blue Shield, CIGNA, Humana, United Health Care, Pacificare, HealthNet, AETNA, etc.) and Private-Pay accounts. The incumbent participates in billing systems design to insure maximum collection of revenue; establishes policies and procedures required for effective billing and collection processes; and responds to issues and concerns of senior management. Supervision of clerical and billing is required. Work is performed under the general supervision of the President and Chief Operating Officer.  The billing supervisor position evaluation will be results-oriented.

Essential Functions:

•     Coordinates and manages the work of the billing and collection staff;

•     Performs technical analysis of payor activity;

•     Advises the department regarding billing and collection issues;

•     Evaluates and resolves ambulance billing system problems;

•     Reviews, coordinates, and updates all compliance issues regarding Federal, State, and City rules and regulations;

•     Reviews, coordinates, and updates all payment options and methodologies to insure accurate and timely collection of revenue;

•     Reviews, coordinates, and implements all changes to payor claim submission processes;

•     Prepares and presents formal and informal instruction to personnel;

•     Conducts program presentations before staff members;

•     Prepares and administers the annual billing and performance reports;

•     Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and work cooperatively and jointly to provide quality seamless customer service;

•     Motivate employees to promote pro-active thinking in problem solving; 

•     Communicate regularly with senior management regarding status of work in progress;

•     Ensure that all the group credentialing needs are addressed and monitored on a timely and consistent basis;

•     Prioritize projects and delegate to appropriate parties.  Performs other duties as needed.

 

Required Knowledge, Skills and Abilities:

Knowledge of:

•     California plan rules, regulations, and detailed provisions of claim submission requirements;

•     Medicare rules and regulations;

•     Health Insurance Claim Form (HCFA-1500) requirements for medical billing purposes;

•     Accounting principles and practices;

•     Commercial insurance claim requirements;

•     Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance;

•     Electronic claim submissions and remittance procedures;

•     Principles and practices of supervision and personnel management.

 

Ability to:

•     Perform a broad range of supervisory responsibilities over others;

•     Develop and implement plans, policies and procedures for billing and collection operations;

•     Read and interpret financial statements and other billing reports;

•     Communicate orally with customers, co-workers, and vendors in face-to-face, one-on-one settings, in group settings, or using a telephone;

•     Comprehend and make inferences from written material in the English language;

•     Enter data or information into a terminal, PC, or other keyboard device;

•     Submit claims, collections, in electronic medical records

•     Work safely without presenting a direct threat to self or others;

•     Produce written documents with clearly organized thought, using proper English sentence construction, punctuation, and grammar;

•     Work cooperatively with other employees;

•     Monitor or observe data to determine program problems;

•     Remain sitting for long periods of time while working at a computer.

 

ACCEPTABLE EXPERIENCE AND TRAINING:

§         High School graduate and/or equivalent required; 

§         Requires 2 years medical billing/auditing/collection experience for all insurances and third party claims;

§         Must have current working knowledge of modern office practices and working knowledge of all insurance types and their guidelines including the ability to read and interpret EOB’s; 

§         Working knowledge of current ICD9 and CPT4 coding systems required; 

§         Basic word processing and spreadsheet knowledge required;

§         Leadership abilities; 

§         Good oral and written communication skills; 

§         Work in-group settings and able to deal with public professionally; 

§         Thinks intelligently, capable of making logical decisions and comprehends verbal and written instructions; 

§         Ability to function in a multi-tasking environment; 

§         Ability to view a monitor for extended periods of time;

§         Five years of experience developing, evaluating, using, and maintaining billing and collections systems;

§         At least two years of progressive experience supervising staff, preferable related to performing billing and collections activities;

§         Possession of a bachelor’s degree in business, public administration, management, or other related field;

§         Other combinations of experience and education that meet the minimum requirements may be considered;

§         Ideal candidate will also have certification by AAPC in medical coding, auditing, or Compliance in addition to the above points.

 

Compensation 

Our company provides a competitive salary and a comprehensive benefits package, including
health, dental, life, 401(k) retirement plan with employer matching, and paid time off. Visit our website at: www.famdoc.org.