Job Summary:

The Supervisor is responsible for Workers’ Compensation Billing and surgical authorizations. They will be well versed in all aspects of authorizations, medical treatment guidelines and accounts receivable management including but not limited to billing, claim corrections, reconciliation, Insurance refunds/credit balances, customer service, and follow-up. This includes reviewing workers’ compensation claim information to ensure accuracy and provide feedback to the clinical and non-clinical areas regarding claim errors and/or denials. In addition, responsible for all other aspects of workers’ compensation collections, resolving customer billing problems and reducing accounts receivable delinquency. Workers’ Compensation Billing Supervisor is a hybrid position.

Duties and Responsibilities:

• Demonstrate our Core Values of being Patient Centered, Team Focused, Service Driven, Accountable, and Innovative every day

• Work closely with Director of Revenue Cycle Management to identify best practices that maximize the accuracy, efficiency, and effectiveness of the team.

• Oversee Workers’ Compensation Billing and A/R Clean up, Collections and Review of insurance responses (NOD).

• Oversee entry of surgical authorization requests and ensure timely processing of responses.

• Ensure Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner.

• Prepare, analyze, and present reports to support data driven decision-making for the team.

• Maintain employee dashboards with key performance indicators to ensure direct reports are consistently achieving performance standards.

• Facilitate performance evaluations, coaching, and recruiting efforts for additional staffing.

• Communicate with providers to update and train on WC processes.

• Assess team adherence to coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies

• Uphold standards in accordance with the Corporate Compliance policies and the Code of Conduct; escalate any violations to the compliance officer

• Provides long term strategic and daily operational management.

• Act as a liaison among internal and external stakeholders who impact the success of the billing and coding department and the practice

• Performs other related duties, which may be inclusive, but not listed in the job description

• Fill in staff functionality, when necessary, as a working team lead.

Qualifications

Requirements and Qualifications:

• 2-3 years of experience in Workers’ Compensation Billing and AR collections; preferably in physician office setting.

• Medical Appeals and Denials: 2-3 years. (Required)

• Minimum of 2 years knowledge of insurance verification and eligibility experience. (Required)

• Orthopedic medicine billing knowledge and experience (Preferred)

• Knowledge and experience with OnBoard, Carisk. (Preferred)

• Knowledge and experience with Medent EMR. (Preferred, but not required)

• High School Diploma or equivalent. (Required)

• Emotional maturity and ability to create change in an environment where the structure may evolve rapidly.