FLSA Status

Nonexempt

Job Role Summary

The EH/SEMHC Billing and Follow-Up Supervisor assists the Manager of Billing in his/her job responsibilities as directed or assigned by the Manager of Billing of Patient Financial Services.

Essential Functions and Responsibilities

• Proactively contributes to Eskenazi Health’s mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence
• Accomplishes leadership objectives by selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining staff; communicating job expectations; planning, monitoring, appraising job performance; adhering to policies and procedures and implementing corrective actions
• Supervises daily tasks of the PFS Hospital / SEMHC billing and SEMHC follow-up team
• On-boards new hires, developing and maintaining an itinerary of training and mentoring interactions to ensure new hire has received in-depth training of payor and departmental policies before the end of the 90 day probation period
• Completes performance reviews annually for staff that reflect monthly one on ones with team members to provide them with ongoing education, performance feedback including individual and team metrics related to quality and productivity, and mentoring their development and achievement of individual goals
• Communicates effectively and appropriately with internal and external customers
• Prepares and presents organizational and Revenue Cycle updates for team members as part of monthly staff meetings that promote ongoing education and development of employees for whom this leader is responsible
• Prepares for and conducts employee face to face reviews in partnership with leadership
• Completes HR/Payroll functions for employees ensuring staff receive appropriate and timely feedback regarding their time and attendance records
• Manages and oversees the daily operations of the PFS Hospital / SEMHC billing and SEMHC follow-up teams. Monitors receivables performance metrics and provides regular reporting of operational achievements and concerns resulting in changes in performance metrics related to Patient Financial Services operations
• Fulfills operational leadership needs by identifying process improvement opportunities, developing and deploying plans to achieve improvement, and preparing presentations of improvement projects and measured outcomes
• Collaborates with Revenue Cycle, IT, and claims administration staff to validate and improve procedures and systems used for the preparation and submission of claims to ensure compliance with payor requirements and effective capture of appropriate reimbursement of hospital services
• Guides employee actions by researching, developing, writing, and updating billing policies, procedures, methods, and guidelines
• Updates job knowledge by participating in educational opportunities; reading professional publications.
• Coordinates the daily operations for PFS Hospital / SEMHC billing and SEMHC follow-up teams to ensure appropriate cash flow is maintained while achieving a high level of patient satisfaction across all levels of the organization with minimal complaint.
• Reviews and approves adjustments and/or contractual write-offs for assigned personnel up to approved level within 48 hours from request.
• Reviews the credit balance process to ensure timeliness of resolution and refund processing for SEMHC only.
• Handles difficult or problem patient account cases and takes calls from the customer services lines when needed; responds to emails and voicemails daily.
• Collaborates with clinical, billing research team, and compliance to validate and improve procedures and systems used for the preparation and submission of research claims and/or invoices to ensure compliance with payor requirements and effective capture of appropriate reimbursement of hospital services.

Job Requirements

• Associate's degree in Business or Healthcare administration or related field with 5 year progressively responsible Hospital/Professional Billing experience or 7 years progressively responsible Hospital/Professional Billing, In lieu of degree.

• Experience with billing Medicare, Medicaid, and Commercial Insurance

• Experience in Physician, Hospital, DME, and Specialty Billing to include Behavioral Health

• Medical terminology knowledge

• * HBI certification as a Certified Patient Financial Service Specialist within the probationary period

• * HBI Revenue Cycle Leadership Certification required at hire or must be obtained within one year

• Three to Five years previous progressive leadership for team members and vendor personnel

Knowledge, Skills & Abilities

• In depth knowledge and the ability to translate code set for billing of federal, state and regulatory laws. The ability to follow Eskenazi Health Services policies and procedures, and of Indiana State Department of Health regulations

• Microsoft Excel skills to include ability to build new worksheets, import data, sort data, use basic formulas, and pivot tables; Microsoft Word proficiency to write policies/procedures and correspondence; proficiency in Microsoft PowerPoint, Microsoft SharePoint and other programs designated and used by the organization

• Excellent oral and written communication skills with the ability to present information to groups of clinical and non-clinical staff Ability to lead, supervise and motivate personnel

• Excellent customer service skills

• Ability to act professionally, be team oriented, and take solution-driven approaches to problem solving for all types of issues

• High level of professionalism and ethical behavior

• Knowledge of reimbursement methodologies, payor coverages, State/Federal programs providing healthcare benefits and payments

• Knowledge of assigned payer(s) billing requirements and regulations

• Ability to learn software quickly and interpret instruction manuals

• Must be capable of completing tasks within given time frames and be productive and goal oriented

• Ability to work independently and within a team with instructions and to deal with problems effectively in collaboration with peers and staff

• Ability to quickly learn and use payer and hospital patient accounting systems

• Possess knowledge of Health Care Procedure Codes and Uniform Billing standards

• Ability to multi-task in a fast paced environment

• High level of interpersonal, problem solving, and analytical skills

• Managing AR by minimizing effective clean claim rate less than 7 days

• Maintaining monthly rounding, productivity and quality measures to assigned staff members.

• Cooperate with claims administration team to minimize claim errors

• Ability to research and interpret research billing guidance effectively in collaboration with staff and peers.