Medical Business Office Supervisor

Job Description

Job Description

The Business Office Manager is responsible for supporting the professional billing process, closely monitors all outstanding accounts receivable to ensure the timely and accurate processing of all claims for services rendered to our patients.

Essential Functions:

· Runs/collects copay's daily.

· Obtain prior authorizations for necessary plans that require prior authorizations.

· Ability to utilize software applications to process claims, research patient accounts and billing statements.

· Responsible for following and interjecting action to facilitate the entire revenue cycle from charge entry through insurance processing and full insurance payor and patient payment in full.

· Answers telephone, and responds to inquiries from insurance carriers, patients and co-workers.

· Retrieve messages from voicemail and execute the requests or forward to the appropriate personnel to ensure a timely resolution.

· Responsible for the collection process, which includes evaluating and reporting delinquent accounts directly to the collection agency, as well as calling patients for overdue balances and sending collection letters.

· Establishes payment plans to help patients manage payment of bills while also managing patient access for patients with inactive accounts from non-compliance to the financial policies.

· Maintain and evaluate daily audit trails and claim denials, rejections, and scrubs

· Investigate and resolve billing discrepancies resulting in overpaid/underpaid accounts.

· Identifies and imports all electronic remittances from each contracted third-party payer website.

· Analyzes and processes all payments, adjustments, rejections and deductibles that were not posted electronically.

· Posts all non-payment explanation of benefits (EOBs) and enter accurate rejection codes to ensure account flows to the correct Accounts Receivable Analyst.

· Posts all ACH transfers and manual deposits including the readying of checks received for deposit.

· Makes deposits of all processed checks for the day. Responsible for checking to see if deposits from all the offices equal at the end of the month.

· Confers with doctors, nurses, providers and other health personnel to assure complete, current, and accurate medical records.

· Operate a computer to process, store, and retrieve health information while following HIPPA regulations in all actions and communications.

· Possesses a thorough understanding of managed care contracts and their limitations.

· Acts as liaison between all insurance company representatives. Stays informed of third-party regulations and requirements by reading all newsletters and periodicals published by different insurance companies.

· Maintains working knowledge of CPT and ICD-10 codes.

· Prints patient statements and submits patient claims electronically or on paper as indicated.

· Locates EOBs and receipts, as well as medical charts.

· Keeps track of problems and resolves issues.

· Processes refunds and credits for patients and insurances.

· Maintains a full understanding of the different insurances and how they are billed.

· Understands and submits claims via web and paper.

· Other duties may be assigned.

Qualifications:

· High school diploma or general education degree (GED).

· Medical Billing and Coding Certification required

· 4 years minimum billing experience; or an equivalent combination of education and experience.

· Experience with Availity required.

· Experience with medical practice/hospital EMRs

· Knowledge of ICD-10, CPT, HCPCS codes and documentation guidelines

· Working knowledge of third-party insurances

· Effective communication skills

· Detail oriented, outgoing, and professional.

· Ability to work independently and as part of a team

· Prior customer service representative experience beneficial

Summary

As a Business Office Manager you will be integral to optimizing the financial processes within our healthcare organization. Your primary responsibilities will include managing medical billing and coding, ensuring compliance with ICD-10 and CPT coding standards, and facilitating effective communication with patients and insurance providers. Your core skills in medical collections and EHR systems, combined with premium skills in DRG and HCPCS coding, will enhance our revenue cycle efficiency. Join us in delivering exceptional service and support to our patients while contributing to the financial health of our organization.

Schedule:

• 8 hour shift
• Day shift

Work Location: In person