Medical Billing Supervisor

Medical Billing Supervisor

Location:

12490 Ulmerton Rd., Largo, FL

Schedule:

Monday - Friday 8am to 5pm

This position performs complex, technical, analytical, and financial work specializing in supervising a variety of functions associated with the execution of an ambulance billing revenue cycle.

• Execution of the Emergency Medical Services (EMS) medical billing system with emphasis on ensuring funds due to the County are received from public and private insurance companies, including The Center for Medicare and Medicaid Services (CMS);
  Monitoring the quantity and accuracy of activities performed by subordinate staff;
• Development of work plans;
  Developing and maintaining performance standard associated with various functions;
  Appropriately apply Pinellas County Human Resource Rules and Departmental policies and procedures;
• Resolving elevated complaints from the public and professional partners;
• Coordination with the County Attorney’s Office as necessary to resolve legal related billing issues;
• Expert knowledge and independent application of State and Federal regulations governing healthcare:
• Knowledge of standard medical terms;
• A high degree of independent judgment in applying concepts such as medical necessity;
• Applied knowledge of billing nuances related to private and public insurance carriers, hospitals, hospices, Veterans Administration, and skilled nursing facilities;
• Staff training and assisting staff to resolve complex billing issues:
  Perform deep-dive audits of specific accounts, payers, or the work performed by an individual;
• Drafting processes and procedures consistent with applicable regulations and/or specific payers;
• Interpretation of complex regulations and Department procedural billing policies; and supervisor of subordinate staff.

The nature of assignments requires the ability to comprehend complex material to instruct staff and audit for appropriate outcomes.

• Supervise, train, and instruct subordinate staff in the execution of various billing activities;
• Perform deep-dive audits, and review and analyze the output of Quality Assurance (QA) pre-and post-billed reports;
• Develop, maintain, and track various performance measures;
• Conducts specific audits to discern billing trends and identify performance improvements;
• Research and resolve complex billing issues;
• Monitoring billing activities to ensure compliance with billing regulations governing healthcare and Departmental policies;
• Ensure the accurate application of claim payments and the proper next billing step occurs;
• Determine the appropriate payer based on the circumstance of the transport and applicable State and Federal laws;
• Provide technical assistance on insurance verification, billing processes and procedures, and secondary billing actions;
• Maintain performance data and billing metrics;
• Handles elevated complaints from the public, vendors, or professional partners;
• Monitor assigned hospital and skilled nursing facility accounts for timely payment, payment trends, and resolution of billing issues;
• Interprets medical information provided on ambulance Patient Care Reports, Physician Certification Statements, hospital records to determine medical necessity, level of service, and assignment of the appropriate International Classification of Disease (ICD) coding;
• Conduct investigations and audits to resolve problems associated with misapplied funds or dormant accounts;
• Develop work plan and prioritize work assignment for subordinate staff;
• Performs a variety of tasks related to an automated office environment;
• Processes credit card payments via phone;
• Prepare status reports and performs special projects as required;
• Performs other related job duties as assigned.

• Six (6) years’ experience in supervision, work planning, medical billing, or claim analysis or an equivalent combination of education, training, and/or experience.
• An equivalent combination of education, training, and/or experience.

• Assignment to work a variety of work schedules including compulsory work periods in special, emergency, and/or disaster situations
• Employee’s name must not appear on the…