Position Summary:

The Hospital / Professional Insurance Billing Supervisor is responsible for assisting with planning, directing, organizing, monitoring and staffing departmental services subject to policies, budgets, objectives and directives mandated by regulatory agencies, DNV and the hospital executive team in collaboration with the Patient Financial Services (PFS) manager. Oversees and coordinates the insurance billing function for Bozeman Health and all related entities, to include insurance follow-up related to no response, returned claims, denied claims, or claim edits preventing claim submission. Supports billing staff in maintaining team discipline to support the accurate and timely claims development and submission to payers to maximize reimbursement for the system. Conducts training and education for all billing functions to prevent and mitigate returned claims or claims denied due to lack of timely response or timely filing requirements. Collaborate and coordinate with other Revenue Cycle functions or departments to resolve discharged not billed (DNB) or claim edits that are preventing timely claim submission. Monitor denials, returned claims, claim edits, and payer claim processing behavior to assist with identifying systemic issues that may require process improvement to strengthen the health of the Revenue Cycle as well escalating identified concerns to the PFS manager.

Minimum Qualifications:

Associate's degree in Business or Accounting; an equivalent combination of education and experience will be considered
Three (3) years of experience in a medical billings and claims
Three (3) years of supervisory experience
Prior experience with Epic billing

Prior experience in healthcare administration, revenue cycle, or accounts receivable management
Knowledge of electronic healthcare payment transactions
Regulatory knowledge required for PPS and CAH Hospital, Provider-Based, Free-Standing Clinic, and Swing Bed Billing
Preferred: Bachelor’s degree in business or related field

Essential Job Functions:

Assists department leadership with broad operations to ensure the provision of comprehensive departmental services in compliance with all regulatory agencies and hospital requirements
Ensures a collaborative departmental approach to long-range strategic operational planning, care and service design and development of organizational policies, which reflect the mission of the organization
Coordinates and oversees the organization-wide departmental services. Continuously assesses, measures and improves departmental performance utilizing key performance indicators. Helps plan initiatives to increase performance as needed
Demonstrates responsible management of all departmental resources
Monitors quality and productivity levels for all billing staff members
Manages WQ assignments in Epic and ensures accounts are not left unworked
Demonstrates clinical/technical and supervisor competency. Ensures staff professional needs are met
Leads, teaches, inspires, helps and consistently demonstrates hospital behavioral standards
Analyzes data and prepares reports on performance as required or requested
Reviews denial and underpayment trends in collaboration with PFS Manager, Contract Specialist, and Compliance as appropriate and follow up staff to develop improvement initiatives; communicated with payers to resolve issues and foster working relationships
Identifies payer trends and communicates with PFS Manager for escalation
Ensures timely billing and proactively investigates and addresses potential billing process inefficiencies
Approves appropriate account adjustments within identified thresholds and ensures PFS Manager is aware of trends in adjustment spaces (timely filing etc.)
Oversees recruiting, hiring, and training practices; monitors and provides performance evaluations for billing staff
Works with external resources as appropriate and brings issues that arise to the PFS Manager

Knowledge, Skills and Abilities

Strong leadership managerial skills; ability to plan, delegate, train, monitor and improve work performance
Demonstrates ability to lead to and motivate staff
Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
Ability to work in a busy and stressful environment
Familiar with business and medical terminology, billing codes, and coding systems (ICD-10, HCPCS, CPT)
Strong interpersonal, organizational, multi-tasking, verbal and written communication skills
Creativity, problem analysis and decision making
Exercises tact, discretion, sensitivity and maintains confidentiality

Detail oriented, organizational skills and the ability to prioritize
Standard office equipment and computer applications; MS Office, internet applications and proficient in Epic.
Ability to work varied shifts

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by the personnel so classified.

77211370 Patient Financial Services