Job Title
Supervises the department responsible for creating claims, reimbursement follow-up, denials, customer service, cash flow, and receivables.
Work Model: Remote, non-exempt
Salary: The pay range for this position is $24.92 (entry-level qualifications) - $37.37 (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior billing/leadership experience.
Essential Functions of the Role:
- Assures billing and collection procedures are timely and compliant with regulatory authority.
- Maintains in-depth knowledge of all billing and collection regulations and makes recommendations for policy and procedure changes.
- Resolves escalated billing, reimbursement, and customer service issues in accordance with established policies and procedures.
- Monitors results of quality assurance reviews and sets goals for improvement and training requirements.
- No compliance reporting issues are identified.
- Evaluates correspondence, denials, reimbursement, and customer reaction to identify need for process changes.
- Reviews trend analysis of charge and billing issues, reimbursement, denials, and customer responses and initiates process corrections.
- Coordinates with appropriate vendors and payer representatives to clarify and resolve billing and reimbursement issues.
- Interprets customer feedback into enhanced customer service.
- Supervises follow-up of claims and accounts.
- Monitors target files, worklists, and phone calls to assure policies and procedures are followed and adjust directions accordingly.
- Coordinates with various Scott & White departments to identify issues and improve data capture and data sharing.
- A/R days are within targeted levels.
- Monitors account payment, adjustment, and reimbursement issues.
- Notifies management of any changes in reimbursement and after thorough research makes recommendations to rectify the issues.
- Reviews worklists and reports to ensure timely and appropriate application of payments and adjustments.
- Monitors credit adjustment transaction reports and assures employees comply with departmental procedure.
- Provides reports to manager.
- Projects are completed as assigned by the manager.
- Participates in the development, installation, and training of all new system software applicable to the department.
- Specific assignments are finished on time and are thorough and complete.
- Escalates to the manager any system issues beyond the scope of their peers.
- Attracts and retains qualified staff.
- Hires and ensures appropriate training of qualified staff.
- Consistently follows department-specific policies and procedures such as time and attendance, security, food, appearance, etc.
- Maintains open communication with staff and provides detailed and thorough policies and procedures.
- Mentors and empowers staff to make them successful.
- Performs other position-appropriate duties as required in a competent, professional, and courteous manner.
Key Success Factors:
- Three to five years experience in health care related field required.
- Three to five years previous supervisory leadership experience preferred.
- Knowledge of Healthcare Accounts Receivable management required.
Qualifications:
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 3 Years of Experience
- Serving as lead on an RCO team
- Multiple payor types knowledge to include Worker's Comp
- Experience with performance metrics such as AR days, denial rates and/or productivity.
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.