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    Revenue Department Supervisor - Atlanta, United States - PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC

    PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC
    PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC Atlanta, United States

    3 weeks ago

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    Description

    Job Description

    Job Description

    Provide leadership and supervision to the Medical Billing and Authorization Departments, while working closely with the Revenue Department Manager. Develop, implement, and oversee policies and procedures to ensure efficiency and accuracy.

    MINIMUM REQUIREMENTS

    • Medical billing and coding certification is required.
    • Three years previous experience as a Billing supervisor/manager in a healthcare setting.
    • Two years previous experience researching unpaid and denied insurance claims.
    • Familiarity with Modernized Medecine (ModMed) EHR software a plus.
    • Knowledge of reimbursement and billing to include CPT, ICD10, DME, insurance verification, and obtaining prior authorizations.
    • Must be able to run financial reports and ensure monthly balancing.
    • Possess the ability to approach situations with an innovative mindset and think outside of the box.
    • Must have familiarity with secondary billing, appeals and contractual adjustments.
    • Ability to understand, write, speak and follow English instructions. Bilingual abilities preferred.

    MENTAL AND EMOTIONAL REQUIREMENTS

    • Must be able to exercise judgment and make decisions independently.
    • Ability to use excellent communications skills.
    • Ability to use problem solving skills effectively.
    • Ability to manage stress appropriately.
    • Ability to manage time efficiently.
    • Ability to handle multiple projects and prioritizes effectively.
    • Possesses common sense understanding to carry out instructions/guidelines furnished in oral and written form.

    ESSENTIAL FUNCTIONS
    Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. The following are the essential functions of the job.

    Duties:

    1. Responsible for the overall direction of the billing and prior authorization departments.
    2. Maintain training manual and train staff members on all aspects of their position.
    3. Stay abreast of insurance rules pertaining to billing and prior authorizations, as well as ensuring the staff is aware and trained.
    4. Balance department monthly and work with the Controller to resolve any discrepancies.
    5. Review the entire billing and authorization processes, the effectiveness of the protocols, and assess staff roles to improve the overall productivity of both departments.
    6. Work with insurance companies and adjusters to resolve problem accounts, re-file and reopen claims, and file appeals.
    7. Work with staff to handle questions and issues regarding charges, payments, and denials, and follow up to ensure they get resolved.
    8. Complete monthly productivity reports to ensure departments are meeting company standards.
    9. Evaluate insurance contracts and update fee schedules accordingly.
    10. Conduct audits on encounters, coding, and payments for accuracy.
    11. Analyze reimbursement procedures and accounts to obtain maximum reimbursement.
    12. Produce monthly reports for various accounts and turn into the Controller/CEO.
    13. Perform other duties and special projects as assigned.

    Job Type: Full-time

    Benefits:

    • 401(k)
    • Dental insurance
    • Employee assistance program
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Experience:

    • medical billing supervising: 3 years
    • researching unpaid and denied insurance claims: 2 years (Required)

    License/Certification:

    • Medical Billing and Coding Certification (Preferred)

    Work Location: In person

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