Medical billing supervisor job description

+ Coordinate with Admissions the appropriate pay source for new admits, re-admits, Therapeutic Leaves, and Hospital Leaves.

+ Obtains and verifies new patient's insurance information and reporting census information as requested.

+ Consults with residents, families, the DHHS case manager, and resident attorneys to identify appropriate insurance plans for billing, ensures documentation is complete, and ensures the Medicaid approval process is acquired within the time allowed.

+ Audit Admissions, Social Services, and MDS clinical data requirements to ensure compliance with Medicare A, B, C, and Medicaid Accounts Receivable regulations.

- Post all cash and follow-up on missing payments or short payments including identifying uncollectable accounts and prepare documentation to submit to the collection agency. - Verify with the MDS Coordinator timing of Level of care Determinations (LOCD). Work with MDHHS Provider Support to resolved LOCD problems. - Review denied claims or denied prior authorizations. Acquire the appropriate documentation to appeal or challenge denial. - Audit weekly patient's insurance coverage and meet with Interdisciplinary Team to verify PPS requirements are being reviewed. - Validate ancillary charges and ICD-10 codes before processing claims. - Prepare monthly invoices for private pay residents and submit hospice reconciliation report to hospice vendors. - Coordinate with the Unit Coordinators and Medicare Coordinator the approval for patient's schedule appointments outside the facility and their transportation needs. Review and understand the facilities vendor contracts (Therapy, X-Ray, Lab, etc.) to validate the correct rates or fee schedules are billed. Resolve any discrepancies and code invoices for AP processing. - Performs other related duties as required and directed. Requirements:
+ 2+ year of experience - Required

+ High School Grad or GED - Required

+ Healthcare experience- Required

+ UBO4 experience - Preferred

As an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability.

A Business Office Department of Saint Peter's is seeking a Biller Service Representative (Medical biller with Medicare/Medicaid experience) to join its team.

A Biller Service Representative acts as liaison between hospital and/or insurance carriers or patients/guarantors to ensure accurate and timely billing and collection process from the time of discharge until accounts are paid or become patient responsibility.
You will:
Ensuring account accuracy
• Reviewing daily claims to ensure submissions are clean and timely.
• Monitoring charges/modifiers/CPT-4s/HCPCS/payments/DRGs/ICD-10 coding.
• Reviewing outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances.
• Submitting timely and accurate adjustments/notes/patient balance transfers and medical record requests.
• Working with management team and notifying of notifying of issues that arise with payors/departments/etc
• Resolving account issues and problem solving independently whenever possible
• Using technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.)
• Managing denials and appealing administrative claims.
• Understanding denials and how they should be handled.
• Sending clinical denials and downgraded claims to appropriate parties to ensure timely appeal.
• Ensuring claims denied at time of billing are distributed to appropriate parties for review.
• Updating and correcting accounts with assistance of originating departments (charges/authorizations/insurance issues)
• Following departmental and hospital policy and procedure. (This includes HIPAA guidelines and Federal guidelines.)
• Understanding payor contracts and billing guidelines; revenue codes and payor specific requirements; and payor/plan codes.
You Need:
High school diploma or equivalent. One (1) or more years medical billing experience or related responsibilities. Hospital billing knowledge strongly preferred. Medicare Medicaid experience
Proficiency in Microsoft Word and Microsoft Excel. High level of interpersonal skills necessary to work effectively with Patient Accounts personnel as well as other hospital department and outside agencies. Comprehensive knowledge of billing, A/R follow-up and collections. Current knowledge of third-party payers, State and Federal agencies with regards to Patient Accounting. Ability to consistently meet deadlines, to concentrate and pay attention to details.
Pay Grade: 114



Job Posted by ApplicantPro

Review encounters for all payers’ sources and maintain no more than 1% errors. Initiate investigation and correction for all discrepancies found in the encounters. Maximize the revenue following the individual payer guide lines. Initiate and investigate cover and non-cover services from all payer types. Provide weekly updates to the billing supervisor of all discrepancies found on the encounters. Review all accounts for potential re- bills, adjustments and write offs. Maintain payment posting up to date to better track the unpaid charges.

Principal Responsibilities:

1. Review all encounters for discrepancies on a timely manner to avoid submitting encounters with error to the various insurances.
2. Generate encounters verification forms for each date of service and submit weekly.
3. Enter and retrieve patients’ Medical data in the patient management system, update information as necessary.
4. Consult with administrators, as necessary to resolve eligibility, documentation, coding, procedures and diagnoses issues.
5. Post payments for the various payers, run the payments entered report to support the payments posted.
6. Review and track payments of all submitted charges/claims, reconcile visits and apply appropriate contractual adjustments and write offs.
7. Weekly encounters error report.
8. Other duties as assigned.

Requirements:

1. Must possess a Billing Certificate and High school Diploma or equivalent.
2. Must have at least 1 year of Medical billing and collection experience in a Medical office setting.
3. Experience with Medicare, Medi-cal, Cross over insurances, HMO, County and Sliding Fee Discount billing and collection.
4. Typing and computer proficiency skills.
5. Ability to communicate effectively verbal and written; work without close supervision.
6. Detail oriented, well organized and the ability to work in a team oriented environment and under deadlines.
7. Flexible with schedule, willing to travel to multiple sites as needed.

Preferred:

1. Bi- lingual Spanish and English.
2. Microsoft Excel experience.

*JWCH requires employees to be vaccinated with exceptions only as required by law (i.e. medical or religion) .

Employee Benefits: JWCH Institute, Inc., offers competitive salaries for all positions. Employees working 30 hours per week or more are provided a monthly allowance which can be used towards medical, dental, vision, and life insurance premiums. The agency offers sick leave and vacation accrual, 11 paid holidays, jury duty pay, mileage reimbursement, employee parking, direct deposit, credit union, and an employee assistance program. In addition JWCH offers a 401(k) Profit Sharing plan to employees who work a minimum of 1,000 hours per fiscal year.

Wesley Health Centers, JWCH Institute is an equal opportunity employer.