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Job ID: 972910
Facility: ECU Health
Dept: Insurance Department
Location: Greenville, NC
FT/PT: Full-Time
Shift: Not Applicable
Reg/Temp: Regular
Date Posted: Nov 8, 2024
ECU Health
About ECU Health Medical Center
ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University. ECU Health Medical Center has achieved Magnet® designation twice and provides acute and intermediate care, rehabilitation and outpatient health services to a 29-county region that is home to more than 1.4 million people.
Position Summary
The Billing Supervisor is responsible for managing the day-to-day operations and staff of the Billing team. The Supervisor will oversee all applicable job functions as stated in organizational and departmental policies and procedures. Ensure monthly, quarterly and yearly departmental goals and objectives are established with direction from the Manager/Director, as well as participate as a team member in meeting objectives and goals.
The Supervisor will provide educational programs with the approval of the Manager/Director to stimulate growth and a professional department. The Supervisor is responsible for keeping informed of new changes in third party regulations, resolving ways to work within any new regulation with the approval of the Director and coordinating any testing or move to production efforts as it applies to billing functions. Ensure all billing/payor edits are continually updated. The Supervisor will also maintain appropriate files, reports and other statistical data as required and provide results of all special projects and provide recommendations for additional revenue opportunities. Coordinates re-bills and adjustments of accounts based on hospital audit results.
The Billing Supervisor will work closely with all Patient Accounts staff, Patient Access Staff, Contracting and Process Improvement, Revenue Cycle Division staff, Medical Records staff, hospital staff, patients and physicians and their staff. The Supervisor will coordinate activities with other departments as approved by the Manager/Director and is expected to demonstrate, through plans and actions, that there is a consistent standard of excellence.
Responsibilities
1. Review and discuss performance standards of the staff under your direct supervision with Manager/Director.
2. Track and trend audit results and provide statistics to Manager/Director.
3. Evaluate and discuss with leadership all billing upgrades, testing, and interfaces before implementation.
4. Oversees the process of entering late charges and credits.
5. Manages billing backlogs and develop corrective action plans.
6. Coordinate and distribute workload to staff, provide training to staff, assist with employee orientation and formulate minutes of meetings and ongoing process and distribute to staff.
7. Manage employee activity such as hiring, job performance, performance reviews and disciplinary actions with appropriate approvals as required.
8. Manage employee relations issues appropriately as they arise and escalate to manager as necessary.
9. Oversee the error correction process and secondary billing to ensure standards are met and monitor applicable job functions as stated in the Policies and Procedures.
10. Conduct training of new hires and ongoing training with medical billing team to assure complete understanding of job duties.
11. Work and completes appropriate reports and workqueues.
12. Supervises employees in performance of tasks associated with billing.
13. Monitors billing processes of the staff to ensure that billing is correct and timely.
14. Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied billings.
15. Ensures that all required information is attached to claims before billing.
16. Ensures appropriate and professional communication with payers and patients.
17. Escalate issues with payers and reports improvement as appropriate.
18. Serves as a resource to staff by answering questions, assisting with problems, and providing training as necessary.
19. Participates in the development of billing policies and procedures.
20. Ensures timely submission and acceptance of claims to all payers.
21. Must be capable of performing all tasks required of billing employees.
22. Uses a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings.
23. Reviews system generated billing to monitor weekly billed and unbilled claims.
24. Communicates issues that are preventing timely and accurate billings to appropriate hospital department Manager for performance improvement process.
25. Reviews Claims Edit List to monitor specific issues, as well as recurring issues and resolution.
26. Recommends future course of action based on data interpretation and recommends system changes, as appropriate.
27. Complete special reports or projects as assigned by Manager or Director.
Minimum Requirements
Bachelor's Degree or high school graduate with five (5) or more years job related experience required.
5-7 years experience in professional/hospital billing
3-5 years supervisory experience required.
CPC certification required (Will allow new hire 12 months to obtain)
Electronic claims submission experience preferred.
Working knowledge of medical terminology and procedures, as well as health insurance, Medicare, Medicaid, Advantage plans.
Strong knowledge of billing principles, procedures, and systems
Knowledge, Skills and Abilities
Ability to work independently in carrying out oral and written instructions.
Apply knowledge of CPT, HCPCS and ICD-10 coding guidelines, billing documentation and documentation standards to daily claims management.
Excellent problem solving, analysis, organizational and time management skills.
Excellent communication and customer service skills with the ability to cooperatively resolve end user issues quickly and accurately, while building relationships with internal personnel and external contacts
Strong attention to details, accuracy and completeness of work products and thoroughness of research, data entry and recordkeeping.
Computer proficiency with Microsoft (Word, Excel, Outlook, Power point) and Internet applications.
Knowledge of third-party physician billing along with a demonstrated understanding of automated processes and claims submission
Demonstrates the ability to accurately manage detailed information.
Proficient in using billing software and Microsoft Office Suite (Excel, Word)
Understands basic medical terminology.
Excellent analytical and problem-solving skills
Ability to effectively communicate with internal teams and external clients.
Leadership skills with the ability to motivate and develop a team.
Works well under pressure
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.