Responsible for oversight of Department of Surgery billing cycle. Ensures that patient appointment and billing information are entered
accurately and timely by performing the tasks her/himself, and by supervising the billing coordinators. Processes professional billing
and resolves problem accounts. Serves as liaison with Department of Surgery clinicians and Professional Billing Office (PBO). Assists
in the development of billing policies and procedures. Keeps abreast of changes in billing and regulations.
1.Supervises and trains billing coordinators
Maintains appropriate staffing by monitoring schedules and absenteeism.
Conducts timely employee performance appraisals and employee disciplinary procedures with appropriate supportive
documentation. Assists staff in setting realistic goals. Provides ongoing guidance and monitors progress.
Interviews candidates as requested and submits hiring recommendations to Director.
Effectively troubleshoots problems and resolves complaints.
Performs necessary administrative duties in the absence of Director and maintains a smooth operation of area of
2.Performs and monitors billing activities and ensures they are completed timely and accurately.
required dates, cancellation of accounts, posting of billing into hospital billing system, and running external interface report.
Corrects errors by working in various applications including electronic medical record and hospital scheduling and billing
resolve a problem.
compliance with various CCI edits
clinicians, follows through with referring physicians and primary care physicians.
physician referral for every new patient and the need for updated referrals. Ensures compliance with procedures/units
approved by Medicaid.
Performs audits to ensure the department bills for all goods and services received by patients.
Monitors patient accounts receivable and works with Finance and Registration departments to resolve reasons for delays
Prepares and reviews scheduled and ad hoc reports. Addresses errors and monitors performance
5.Assists with development and implementation of scheduling and billing policies and procedures and serves as resource for clinical and administrative staff.
Develops solutions to billing problems and implements corrections. Monitors results of billing changes.
Recommends process changes so issues won't reoccur.
Assists in the development of billing policies and procedures and serves as a resource regarding CPT, ICD-10 codes, CCI edits, and modifiers.
Serves as specialty-specific resource to clinicians and administration. Attends meetings, seminars and workshops to keep abreast of current billing changes and information.
Determines coverage rules and regulations of third party payers and verifies information regularly.
Maintains and updates various manuals with current regulations and guidelines.
Updates clinical and administrative staff on ongoing and new billing issues that need attention.
Presents written and oral information clearly and precisely, conveys a depth of knowledge in the subject matter. 6. Promotes effective interpersonal and interdisciplinary relationships.
Demonstrates good interpersonal skills and effectively communicates with Director, other Department of Surgery supervisors, staff, and hospital personnel.
Resolves interpersonal conflicts constructively when dealing with members of the organization.
Facilitates interdisciplinary and interdepartmental work by acting as a role model and encouraging staff to collaborate.
Presents Department in a positive manner to patients, staff, and other hospital personnel. 6. Other duties.
Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care is provided.
Utilizes hospital's cultural beliefs as the basis for decision making and to support the hospital's mission and goals.
Utilizes hospital's Values as the basis for decision-making and to facilitate the Department of Surgery's mission.
Follows established hospital infection control and safety procedures. Performs other duties as needed.
Must adhere to all of BMC's RESPECT behavioral standards.
(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The
above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
Boston Medical Center