Serves as the practice expert for Collection, Reauthorization, and Payment Posting on all processes.
Oversees the operations of the Collection, Reauthorization, and Payment Posting department, including claim submissions, payment posting, accounts receivable follow-up, and reimbursement management. Serves
Audits current procedures to monitor and improve efficiency of Collection, Reauthorization, and Payment Posting operations.
Supervises Collections/Payment Posting office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
Provides, oversees, and/or coordinates the provision of training for new and existing Collection, Reauthorization, and Payment Posting staff on applicable operating policies, protocols, systems and procedures, standards, and techniques.
Coordinates team member requests for time away from work in a manner that does not negatively impact necessary daily functions.
Analyzes trends impacting coding, collection, and accounts receivable and delegates out manageable work list to Collection, Reauthorization, and Payment Posting staff.
Maintains contact with other departments to obtain and analyze additional patient information to document and process of Collection, Reauthorization, and Payment Posting.
Ensures that the activities of the Collection, Reauthorization, and Payment Posting operations are conducted in a manner that is consistent with overall department protocol, and in compliance with Federal, State, and payer regulations, guidelines, and requirements.
Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
Holds bi-weekly staff meetings for Collection, Reauthorization, and Payment Posting to ensure proper Team building and protocol.
Reports all concerns or issues directly to Director of Revenue.
Minimum of four (4) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system, with a deep understanding of medical collections and insurance verification rules and regulations experience preferred.
Two (2) years supervisory or management experience preferred.
Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare and Medicaid.
Working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.
Knowledge of business management and basic accounting principles to direct the billing and coding office.
Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers.
Possess excellent negotiation skills, including the tact required for securing payment or discussing patient's finances, and enjoy working in a health care setting.
Up to date with health information technologies and applications.
Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
Skill in developing, implementing, and administering work processes.
Detail oriented and tolerant of frequent interruptions and distractions from patients and staff.
Effectively communicate with physicians, patients, insurers, colleagues and staff.
Must be proficient in Microsoft Office, including Outlook, Word, and Excel.
Ability to work under minimum supervision and demonstrate strong initiative.
Ability to supervise and train employees, to include organizing, prioritizing and scheduling work assignments to meet practice timelines.
Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
Ability to communicate effectively in writing, over the telephone, and in person.
Position is in well-lighted office environment. Occasional evening and weekend work may be required.