[Hiring] Supervisor, AR Medical Payment Specialist @The Wright Center for Graduate Medical Education

Role Description

The AR Medical Payment Specialist Supervisor is responsible for researching outstanding balances and determining correct action to be taken to ensure maximum reimbursement. Must take the lead on corrective actions for accounts with outstanding balances in a timely manner to obtain reimbursement.

• Responsible for processing correspondence relating to the financial status of an account.
• Recognizes trends for denials and reimbursement issues and reports such to the Accounts Receivable & Collection Manager.
• Monitors Billing Staff performance and productivity and meets with Accounts Receivable & Collection Manager regarding updates on appropriate utilization and quality assurance.
• Work is typically performed in an office environment, but this position may have the option to work from home.

Qualifications

• High school degree or equivalent with knowledge of health care project management OR equivalent combination of education and experience
• 6-10 years of medical billing/claims experience
• Experience in CPT codes and ICD 9 and/or ICD 10 coding preferred
• Detail oriented and timely delivery of projects
• Experience with electronic medical records
• FQHC multi-specialty billing and coding experience preferred
• Experience in Excel and Word preferred

Requirements

• Manage outstanding accounts receivable.
• Resolve outstanding balances, resubmitting claims and providing necessary information to support prompt payment.
• Follow up on outstanding accounts receivable, focusing on maintaining aged receivables within 60 days of days outstanding.
• Make all necessary corrections in the billing system.
• Research and resolve claims rejected by payer.
• Identify billing and coverage concerns.
• Answer patient and facility questions about account balance and status of payment.
• Responsible for triaging workload and prioritizing tasks through proper utilization of staff resources.
• Identify, correct and communicate facility errors to appropriate parties involved and produce corrective action plans accordingly.
• Identify and communicate payment trends to the Accounts Receivable & Collections Manager.
• Research outstanding credit balances and prepare/approve requests for refunds.
• Research and recommend/approve accounts for bad debt write off.
• Develop a strategy the team will use to reach goals and maintain high level of productivity.
• Provide training that team members may need and monitor progress.
• Create reports to update the organization on Billing Department progress.
• Develop policies and procedures regarding all front-end revenue cycle processes.
• Develop trainings to ensure proper co-pay collection at the level of the front desk.
• Periodically, prepares and presents progress reports to the Executive Team, Board of Directors and Staff.
• Works closely with the credentialing team to ensure targets are met for providers to meet timely filing and reduce the rate of claim rejections.
• Meets with payor representatives and is knowledgeable of contractual agreements with regards to reimbursement models.