JOB DESCRIPTION OVERVIEW:
The position is responsible for the overall management of GE IDX Support and Oracle Exceptions departments. This role oversees the workflow, and daily activities to ensure the GE IDX Support and Oracle Exceptions departments meet quality, production, and budget specifications. This position is also responsible for staffing, disciplinary action, training, and enforcing adherence to established policies and procedures. In addition, this role supervises the staff, oversees daily workflow, and ensuring the department meets or exceeds standards for quality, production, and metric performance. This role ensures employees are trained, and consistently follow all TH and Billing Center policies/procedures.
ESSENTIAL DUTIES AND RESPONSIBILITIES:- Plans, organizes, directs, and monitors the assigned area(s), GE IDX Support and Oracle Exceptions.
- Assists with research and development of appropriate denials procedures.
- Hires, trains, and evaluates staff, and administers progressive disciplinary action.
- Creates and maintains policies consistent with HCFS and TeamHealth policies and procedures.
- Updates and submits for approval policies and procedures for department.
- Assures compliance with applicable laws and regulations.
- Informs appropriate Manager(s), Director(s), VP(s) or Corporate when obvious inappropriate business practices are evident that may effect not only reimbursement and accounts receivable management, but also relationships with clients, hospitals, payers and legal status. This includes any noted compliance or HIPAA concerns.
- Runs daily, weekly and monthly reports to assist identifying potential carrier, denial, or billing system issues.
- Processes and monitors the resolution of edit, claim, provider, and system issues.
- Analyzes system data and reports to make recommendations to improve system and/or workflow processes.
- Evaluate carrier requirements and formulate resolution strategies.
- Prioritize assigned projects to meet TeamHealth implementation timelines.
- Monitor workflow, productivity, and quality of work to ensure compliance with established standards, metrics, and departmental goals.
- Monitor KPI's and metrics for the department.
- Facilitate meetings with staff and management to ensure information is communicated and goals are achieved.
- Process optimization/improvement.
- Partners with other supervisors and participates in management meetings and offers ideas to improve systems or workflows and position TH for success.
- Manages department within budget guidelines, assisting in the preparation and monitoring of annual budgets.
- Actively participates in the training/retraining of employees, especially working with new hires in the initial onboarding process.
- Maintains accurate production and quality records.
- Controlling inventory, supplies, and materials necessary for the function of the department.
- Defines and implements a program for quality assurance for assigned areas.
- Actively participates in the leadership of the department and motivating staff.
- Completes employee performance appraisals and administers disciplinary action where appropriate.
- Maintains accurate records of disciplinary actions, developmental conversations, and employee training sessions for their area.
- Manages staff and procedures ensuring systems operate efficiently and maintains effective personnel relations.
- Evaluates and refines systems to provide the most efficient, cost effective, and workable flow.
- Develops long-range and short-range goals and objectives.
- Proactively keeps the Manager/Director/Vice President updated on the status of workload and any potential problems that may arise.
- Performs any and all of the duties assigned by the Manager/Director/Vice President.
SUPERVISORY RESPONSIBILITIES:- The Supervisor is responsible for overall, day to day management of the department.
- Supervises Oracle Exceptions and GE IDX Support staff members.
Job Requirements:
QUALIFICATIONS / EXPERIENCE:
- College education or 3-5 years of equivalent experience in a medical billing setting, with an emphasis on reconciliation and payment posting preferred.
- BS or BA preferred or equivalent of management/supervisory experience in physician billing related field.
- Familiarity with the revenue cycle process.
- Understanding of physician billing guidelines for commercial and government payers in multiple states.
- Excellent written and verbal communication and interpersonal skills.
- Proven analytical skills and ability to work in a structured, fast-paces environment.
- Proficiency in working with systems (GE experience is desirable) and (DMS experience is desirable).
- Must be organized, detail oriented, and meticulous with all tasks.
- Astute problem solving skills and ability to interrelate and convey information professionally.
- Medical billing experience with knowledge of the GE system, Microsoft Excel, Microsoft Outlook, and Microsoft Word.
- Dependable, always conforms to standards for attendance.
PHYSICAL / ENVIRONMENTAL DEMANDS:- Ability to meet closing deadlines, and production standards is required.
- Also, may require physical and/or mental stamina to work additional hours beyond a regular schedule and/or more than five days per week.
- Significant workload that may require after hours work and/or additional hours be mandated by Management.
- Regular and reliable attendance is necessary.
- Prolonged work on a PC/computer.
- Physical requirements include but are not limited to sitting for extended periods of time, walking, and bending.
- Periodic travel may be required for meetings and trainings.
- This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions.