Medical Billing Supervisor

Seniority level

Mid-Senior level

Full-time

Accounting/Auditing and Finance

Public Safety

MOS:
None

Education and Experience: A High School Diploma or GED or higher, and five (5) years of medical billing experience including two (2) years in a lead or supervisory capacity.

Licenses and Certificates: Certified Healthcare Financial Professional within one (1) year of appointment. Texas Class "C" Driver's License or equivalent from another state.

General

Purpose:

Under general supervision, supervise medical billing staff and maintain grant program billing accounts.

Typical Duties:

• Administer and supervise medical billing functions. Involves:
  Supervise insurance, Medicare and Medicaid follow-up, collections and financial screening of unfunded patients. Responds to billing inquiries, posting of payments, rejections and other related activities. Function as the fiscal intermediary contact for Medicare and Medicaid programs to include EMS-Fire.
• Handle enrollment and revalidation for Medicare and Medicaid provider enrollment for clinics and physicians enrolled in Medicaid.
• Review work product and processes and coordinate information for reporting purposes.
• Credential health care providers with third party payers such as Medicare, Medicaid, Blue Cross Blue Shield, Superior, and El Paso First.
• Function as the system administrator for Medicaid (TMHP) to provide access rights for eligibility checking, billing and remittance import. Update each site for TMHP access every 60 days and maintain access security for TMHP.
• Research system or processing issues and oversee implementation of solutions. Participate in the revision and implementation of new policies and procedures related to medical billing. Assist in the development and implementation of process and policy changes.
• Assist with issues related to area of responsibility. Provide any additional training requirements of employees and assess the need for additional training.
• Receive and process insurance and patient payments. Process insurance claim forms and follow-up with third party payer sources;
  Re-bill insurance companies, Medicare and Medicaid to secure payment.
• Perform monthly bank reconciliation & track overage/shortage and create journal entries for the same.
• Perform monthly credit card reconciliation for posting revenue to clinic credit card users.
• Track Texas Comptroller grant & ACH payments for department and create journal entries for posting to general ledger.
• Follow up with insurance companies on claims when payment is not received within designated time frames.
• Track daily bank & credit card transactions; implement paperless deposit documentation by having staff scan deposits & backup to shared server available to anyone.
• Conduct monthly clinic audits for Title V & Medicaid compliance.
• Coordinate eligibility requirements with program managers.
• Serve as system administrator for internal control software programs (ABS).
• Track and develop information to be utilized in the Department's costing models.
• Assist in development of budget process for annual City budget.
• Track & compile the quarterly grants data for reporting to Texas Department of Health Services (DSHS).
• Assist in petty cash and deposit/cash custodian functions.
• Compose appropriate correspondence to agencies and program managers.
• Review official medical records with provider documentation and assign appropriate codes for all provider services from current editions of official coding sources.
• Responsible for Department's compliance with Medicare and Medicaid guidelines. Serves as HIPPA officer. Function as safety officer for fiscal services program and serve on safety team as a co-captain on drills & evacuation. Represent Department on Paso del Norte Health Information Exchange and serve on the Privacy & Security Committee. Serve on State of Texas committees for implementing electronic immunization and laboratory reporting.
  
  Perform related duties as required.
• Supervise assigned personnel. Schedule, assign, instruct, guide and check work. Appraise employee performance. Provide for training and development. Enforce personnel rules and regulations and work behavior standards…