Supervisor - Insurance Billing

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Summary:

Type of Opportunity:

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Responsibilities:

The person in this position will:

• Supervises the day to day work of the Insurance Billing team to ensure accurate, timely and compliant billing in accordance with CMS guidelines. Assists manager with monitoring quality and performance standards by reviewing billing reports, developing new methods and processes, and coordinating resources to improve billing and collection efficiency and effectiveness.
• Identifies patterns in resubmitted and adjusted claims. Identifies trends and inconsistencies that require revisions to billing/follow-up guidelines and/or system modifications. Addresses trends with manager.
• Regularly review the effectiveness of billing processes, policies and automation and recommends changes deemed likely to improve the cost to benefit ratio and maximize collection rates
• Ensures that all accounts are processed in accordance with established quality and performance standards by monitoring system generated reports and quality audits, recommending new methods and processes, and coordinating resources to improve billing and collection efficiency and effectiveness.
• Assists manager in performing random reviews of problem accounts. Ensure that all issues are acknowledged and resolved within established time periods.
• Responsible for the hiring, coaching, counseling and disciplinary actions of all employees. Works with Manager to develop corrective action plans when required. Maintains employees work schedules to ensure adequate staffing to accomplish daily tasks and goals.
• Leads team in a manner that ensures high quality customer care focused on building and retaining valuable patient and payer relationships and committed to the delivery of value-added services.
• Acts as a resource to answer questions internally and externally. Ensures open and timely communication with all team members.
• Builds effective and strong teams committed to delivering world-class customer service and achieving organizational goals.
• Performs other duties as assigned by Manager or Director. Assists in Patient Financial Services projects as needed.

Qualifications:

• One to two years of college level courses OR three years of healthcare business office experience in lieu of college level courses.
• Two years experience in healthcare billing and/or collections roles required.
• Proficient knowledge of insurance billing and reimbursement methodologies, including medical terminology, ICD-10, CPT and HCPCS codes required.
• Must be familiar with CMS 1500 and UB-04 claim forms, 837 electronic claims processing, and 835 electronic remittance processing.
• Demonstrated ability to communicate verbally and in writing to customers, providers and peers.
• Good organizational, people and management skills and the ability to function effectively and independently in a fast-paced environment.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.