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Qualifications:
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- Bachelor’s Degree in Business Administration or related field preferred. High School graduate or equivalent required.
- Minimum of two (2) years of previous supervisory billing experience in a hospital setting or five years (5) experience in billing and collection in a health care facility or equivalent is preferred.
- Advanced knowledge of Excel preferred.
- Strong oral and written communication skills.
- Ability to foster an environment that nurtures collaboration, teamwork, and mutual respect.
- Ability to work independently and perform critical work under deadlines.
- Informational needs of the hospital clinical and administrative departments, contract, insurance, government, and government funded payers.
- Knowledge of billing requirements of Medicare, Medi-Cal, insurances, contract payers, and government entities.
- Credit and collection requirements to effect timely follow-up and resolution of accounts receivable balances.
- Demonstrated record of continuing education/training and professional development.
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Duties &
Responsibilities:
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Job Summary
The Patient Financial Service Supervisor oversees the Patient Financial Services (PFS) Department. Directly involved in and responsible for daily operations with the PFS team. Responsibilities include but are not limited to hiring, staff development, managing performance, providing oversight of claims submissions, denial management, payment posting, collections, customer service and understand all areas of the revenue cycle in order to optimize reimbursement.
Duties
- Oversees the billing functions, including the initiation of goals and procedures, overseeing daily operations, and coordinating office efforts to expedite payment of accounts.
- Supervises hourly employees in performance of tasks associated with billing and collection from third party payers. Monitors billing processes of billing staff to assure that billing is correct and timely.
- Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied billings. Determines the accuracy of charge capture, missing charges, late charges, covered and non-covered charges.
- Ensures that all required information is attached to every billing form, TAR.
- Ensures appropriate and professional communication with payers and patients.
- Elevates issues with payers and reports improvement as appropriate.
- Serves as a resource to staff by answering questions, assisting with problems, and providing training as necessary.
- Assists the PFS Director and performs designated duties when they are absent.
- Implements quality and performance improvement measures for the business office.
- Participates in the development of unit policies and procedures
- Ensures timely submission and acceptance of claims to all payers.
- Monitors and creates edits in the electronic billing system to achieve accurate high clean claim ratios.
- Must be capable of performing all tasks required of PFS employees.
- Uses a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings.
- Identifies accounts not selected for billing (ANSB). Reviews system generated billing, collections and medical records abstracting reports to monitor weekly collections, billed and unbilled accounts.
- Communicates issues that are preventing timely and accurate billings to appropriate hospital department Manager for performance improvement process.
- Identifies and collects on underpaid accounts.
- Reviews Claims Edit List to monitor specific issues, as well as recurring issues and resolution.
- Recommends future course of action based on data interpretation and recommends system changes, as appropriate.
- Performs other duties as assigned.
Organizational Expectations
- Provides a positive and professional representation of the organization.
- Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.
- Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience.
- Adheres to infection-control policies and protocols.
- Participates in ongoing quality improvement activities.
- Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
- Complies with organizational and regulatory policies for handling confidential patient information.
- Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
- Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements.
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