Business Office Supervisor/Manager
Business Office Staff
Job Supervisory Responsibilities:
A nonexempt position responsible for the processing and collection of insurance payers.
Essential Job Responsibilities:
- Process electronic and paper claims using Athenahealth EHR
- Analyze outstanding balances to determine appropriate course of action.
- Trace and appeal underpaid, and/or erroneously paid or denies claims with appropriate documentation per payer requirements.
- Verify and adjust accounts according to payer or program specifications.
- Perform collection actions and resubmitting claims to insurances after corrections to minimize days in A/R.
- Accurately document claim issues.
- Prepare adjustments such as refunds, contractual differences, and write-offs for approval and processing.
- Audit, communicate and follow up with providers and staff to provide guidance in correcting errors related to denied or unpaid claims on continual basis.
- Assist staff with billing questions.
- Identify and resolve issues with patient/payer billing issues and complaints.
- Create new provider payer credentialing status and related claims.
- Review accounts for possible assignment to collections; make recommendations to Revenue Cycle Manager and prepare information for collection agency.
- Assigns uncollectable accounts to collection agency or attorney via clinic credit and collection policy.
- Review follow and report monthly, the status of delinquent accounts.
- Continually strive to promo0te and maintain exceptional internal and external customer service.
- Monitor payer websites for medical policy benefit changes. Communicate changes to supervisor and related staff.
- Review bulletins, newsletters and periodicals and attend workshop to stay abreast of current issues, trends and changes in laws and regulations governing claims, processing, coding and documentation.
- Provide suggestions to improve daily collections workflow and inefficiencies.
- Demonstrate working knowledge of ICD-10, CPT and HCPCS codes along with HIPAA laws.
- Comply with all written and stated company policies and procedures.
- Provide back up and support to team members as necessary.
- Work projects as assigned by management.
- Other duties as assigned.
- Working knowledge of ICD-10, CPT and HIPAA laws.
- Knowledge of company medical billing/collection policies and procedures.
- Knowledge of legal and regulatory government provisions.
- Knowledge of business and communication software.
- Skill in establishing and maintaining positive, effective, internal and external working relationships.
- Skill in written and verbal communication and organization.
- Ability to multitask.
- Ability to accurately enter data and examine insurance documents.
- Ability to courteously work with patients, staff, and others.
- Ability to communicate well and interact in a positive manner with management, coworkers and payers effectively and clearly.
- Role model for organization’s core values
- Customer Service: Demonstrates the highest standards for friendly, courteous and caring interaction with patients, physicians, customers, and fellow employees.
- Organization and presentation abilities
- Professional presence
- Communication Demonstrates ability to accept and understand instructions, expresses self clearly and concisely.
- Adaptability/Flexibility Demonstrates the ability to cope with pressure, grasp new ideas and methods, and adjust responses to meet the changing work environment.
- Independence/initiative Demonstrates reliability, followthrough, ability to work with minimum supervision, and desire and ability to accept additional responsibility.
- Emotional Intelligence Maintain basic emotional and social competencies to include self-awareness, self-regulation, motivation, empathy, and social skills.
Equipment operated: standard office equipment including computers, faxes, copiers, printers, telephones,etc.
Education/Experience: High school diploma or equivalent. Some college, knowledge of medical terminology, system and ICD-10 preferred. Minimum of two years medical collections insurance experience preferred.
Physical: Position is in a well-lighted office environment and involves sitting approximately 90 percent of the day, walking or standing the remainder.