Supervisor Billing

Boston Medical Center Boston , MA 02298

Posted 2 weeks ago

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

  • Ensures effective management of staff to achieve and maintain quality services, positive employee relations, and high

productivity/efficiency.

  • Reinforces Boston Medical Center universal standards, cultural beliefs, behavioral standards and gives on-going feedback

to staff.

  • 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

responsibility.
2.Performs and monitors billing activities and ensures they are completed timely and accurately.

  • Performs and monitors billing activities which includes timely and accurate entry of charges, ICD-10 coding, and Medicare

required dates, cancellation of accounts, posting of billing into hospital billing system, and running external interface report.

  • Independently troubleshoots problem accounts on daily external interface report and weekly hospital billing edit report.

Corrects errors by working in various applications including electronic medical record and hospital scheduling and billing

systems.

  • Communicates with inpatient and outpatient clinicians, Registration, Finance and others to obtain missing information or

resolve a problem.

  • Manages Request for Additional Information (RAI) process between coders and providers.
    3.Performs audits and validation of billing and other information. Ensures compliance with third party payers and

accrediting agencies.

  • Validates coding of all charges (ICD-10, CPT codes)
  • Completes various reconciliation procedures; adds appropriate modifiers; corrects CPT code units and minutes, ensures

compliance with various CCI edits

  • Ensures department is in compliance with Medicare. Tracks certifications and re-certifications, communicates with

clinicians, follows through with referring physicians and primary care physicians.

  • Ensures compliance with hospital and third party payer requirements including the need for an approved electronic or faxed

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

and denials.

  • 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).


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Supervisor Billing

Boston Medical Center