Billing Supervisor

Position is responsible for managing the daily processing of medical charges, filing insurance claims and collection accounts. Applicant must have 3 to 5 years of managerial experience with knowledge and understanding of FQHC medical billing and/or coding systems. Knowledge of Federal, State and Private Insurance regulations regarding medical billing and extensive billing compliance. Experience and/or knowledge of computerized information systems specifically with the NextGen medical billing system preferred. Knowledge of federal, State and Private Insurance credentialing procedures preferred. Overtime may be required.Responsible for management of the day-to-day operations of the Accounts ReceivableDepartment ensuring adherence to policies and procedures.Oversees the hiring and supervision of personnel, which includes work allocation,training, and problem resolution; evaluates performance and makesrecommendations for personnel actions, including termination; motivatesemployees to achieve peak productivity and performance.Works with billing staff to establish departmental goals and timelines and updateSupervisor monthly on whether the goals have been met. Informs CFO assoon as possible if there are barriers to meeting goals.Develops or assists CFO with the development and implementation ofpolicies and procedures to ensure efficient and safe operation of the departmentand to meet established goals and timelines.Works with the CFO and other staff in the planning, implementation andevaluation of modifications to existing operations, systems and procedures,especially those related to reimbursement maximization and accounts receivable.Monitors accounts receivable. Responds as needed to accounts receivableproblems.Maintains the tables and information in the practice management system thatsupports patient and insurance billing. Keeps current on updates to the practicemanagement software and communicates changes to staff. As needed, works withpractice management software vendor and clearinghouse to solve billingproblems.Oversees clinic's collection programs. Monitors and evaluates programeffectiveness and progress and works with Supervisor on improvements andchanges.Coordinates with Supervisor on needed training for providers formaximizing reimbursement.Handles patient complaints about fees and billing and decides upon thedisposition of these complaints.Handles complaints and quality requirements relating to billing departmentfunction from insurance carriers and other 3rd party payers and decides uponresolution strategies for these complaints.Works as liaison with other departments to facilitate problem solving and datacollection appropriate to patient and insurance billing.Ensures that all billing and collection activities meet and adhere to Medicare,Medi-cal and other insurance regulations, rules, and laws.Participates in performance improvement projects as assigned.Participates in meetings and committees as assigned.Attends and participates in staff meetings and required education programs.Attends and participates in management team meetings.Follows all CFHC and departmental policies and procedures.Adheres to all applicable laws and regulations.Maintains confidentiality within the workplace and within the community.Demonstrates commitment and alignment to Castle's mission and vision.High degree of confidentiality, integrity and professionalism.Handle protected health information in a manner consistent with theHealth Insurance Portability and Accountability Act of 1996 (HIPAA).Ensure patient and/or insurance refunds are done in a timely manner in accordance with state and /or federal requirements.Ensure that a good audit trail and records are maintained.Verify and update health care changes against established rates for diagnosis, treatment services and supplies, maintains patient accounts via an automated billing system, using standard industry codes to facilitate reimbursement from governmental and commercial insurances, and established pro-rata responsibility to permit prompt collection of patient share.Perform Other Job Duties As Assigned By Supervisor.Knowledge, Skills and Abilities required: Coding Certificate preferred. Ability to supervise and train employees, to include organizing, prioritizing, andscheduling work assignments. Ability to use independent judgment and to manage and impart confidentialinformation. Knowledge and understanding of medical billing and/or coding systems, asappropriate to the position. Knowledge of Federal, State, and Private Insurance regulations regarding medical billingcompliance. Knowledge of computerized information systems specifically in the Nextgen medicalbilling system preferred. Ability to effectively communicate information, policies, and/or procedures in amanner easily understood manner.Ability to correspond with all departments to communicate current and e new changes or situations that may effect the cash flow for the corporation.Ability to schedule and conduct training and seminars on billing policies and procedures (tapes, seminars, reading, and/or hands on).Hold a minimum of one office meeting monthly.Review and trace claims over 45 days old with staff and establishes policies on how to appropriately handle these claims.Ability to develop, plan, and implement short-and long-range goals.Ability to foster a cooperative work environment and create a team working environment.Employee development and performance management skills.Skill in the use of computers.Ability to communicate effectively, both orally and in writing.Ability to effectively communication in English verbal and writing.Bilingual English/Spanish both verbal and written a plus.Behavioral CompetenciesAccountability Role model for Castle's mission and vision valuesCustomer-Focus Listen to the voice of the customer and strive to delight them by exceeding theirexpectationsTeamwork If someone needs help, help themInitiative Be innovative, apply fresh ideas, and continuously improve how you do your workConfidentiality Maintain strict confidentiality and respect the privacy of othersEthical Demonstrate integrity, honesty, and stewardship in all encounters at workRespect Demonstrate consideration and appreciation for co-workers and patientsCommunication Demonstrate the ability to convey thoughts and ideas as well as understand theperspective of othersQUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.EDUCATION And/or EXPERIENCEBA Degree, and/or four to five years related experience and/or training; or equivalent combination of education and experience.Language SkillsAbility to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.Reasoning AbilityAbility to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.PHYSICAL DEMANDS: The physical demands described here are representatives of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.While performing the duties of this job, the employee is frequently required to sit; use hands to finger, handle, or feel objects, tools, or controls; and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl.The employee must occasionally lift and/or move up to 35 pounds. Specific vision abilities required by this job include peripheral vision and the ability to adjust focus.WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.While performing the duties of this job, the employee occasionally works near moving mechanical parts.The noise level in the work environment is usually moderate.