GENERAL SUMMARY OF DUTIES: Responsible for assisting with the oversight of the daytoday activities of the Revenue Cycle Management departments day to day operations and processes.
REPORTS TO: Revenue Cycle Manager
RESPONSIBILIITES Duties include but are not limited to:
Assists the RCM Manager with the daily operations including work assignments staff productivity training and development of staff members
Assists with following up on all claim rejections in the clearinghouse software and makes changes as necessary to refile claims.
Assists with all payor enrollments via clearinghouse
Works in tandem with insurance payers on billing denials and appeals
Ensures and works denials in a timely manner and creates solutions to prevent future denials
Assists with the management of adding new locations into billing software acquisitions
Assists with the management of systems conversion for any new acquisitions
Investigates escalated insurance billing inquiries and inaccuracies and takes appropriate action to resolve.
Completes requests for information from other UD staff and ensures they are handled promptly and effectively to guarantee payment on patient accounts
Prepares reports as needed for various departments and leadership.
Supports leadership in oversight of designated Revenue Cycle Management domestic and offshore staff as needed to ensure all RCM functions are completed within the established timeframes
Accomplishes staff results by communicating job expectations; planning monitoring and appraising job results; coaching counseling employees; developing coordinating and enforcing systems policies procedures and productivity standards.
Conducts team meetings to educate on insurance guidelines claim denials and retraining efforts as needed.
Participates in the selection and hiring of qualified staff ensures an effective onboarding and provides comprehensive training and regular feedback.
Keeps abreast of all reimbursement and billing procedures of thirdparty insurance and government regulations to ensure compliance with current processes.
Meets or exceeds quality and productivity standards as set by RCM leadership
Abides by and promotes HIPAA compliance; maintains strictest confidentiality of patient information
Any other duties and/or special projects as assigned by RCM Leadership.
REQUIRED EDUCATION SKILLS & EXPERIENCE High School Diploma or GED required; 2 years of college or Associates Degree from an accredited college preferred. Two years relevant healthcare experience with a deep understanding of medical billing collections payment posting revenue cycle third party payers Medicare and Federal payer regulations required. Working knowledge of CPT HCPC ICD9/ICD10 codes CMS 1500 UB04 claim forms HIPAA billing and insurance regulations medical terminology insurance benefits and the appeal process is needed for this role. Must be able to operate EMR software preferably eCW and be proficient in multiple Microsoft Office applications with intermediate skills in Excel.
ADDITIONAL SKILLS AND EXPERIENCE Supervisor RCM Accounts Receivable must have or be able to:
Knowledge of business management and basic accounting principles to direct the billing department
Quickly acquire sufficient knowledge of UD policies and procedures to accurately answer questions from internal and external customers.
Ability to make independent decisions when circumstance warrant making prompt and accurate judgments regarding A/R billing and other RCM duties.
Ability to recognize evaluate solve problems and correct errors and to develop processes that eliminate redundancy.
Skilled in establishing and maintaining effective working relationships with other employees patients organizations and the public.
Communicate clearly with coworkers patients and vendors through the telephone email and inperson
Plan prioritize and complete multiple tasks as delegated by RCM Leadership
Ability to work under minimum supervision demonstrate strong initiative and attention to detail
Ability to work under pressure; assess respond and communicate issues in a timely manner
Maintain composure and always set a professional example
PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS Requires sitting and standing associated with a normal office environment. Travel required as business needs dictate.
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