Medical Coding Edit Specialist resolving coding account edits for healthcare provider like e4health. Focused on maintaining accuracy and productivity within coding standards.
About the role
- Billing Supervisor overseeing billing, collections, and cash posting functions for OCHIN’s revenue cycle management. Leading a team to maximize financial health metrics across the organization.
Responsibilities
- oversee the billing, collections, and cash posting functions of the revenue cycle
- provide daily guidance and support to ensure the team meets OCHIN key performance indicators for financial health
- work with the Operations Manager to develop strategic plans to ensure operational efficiency
- work with cross-functional departments to maximize collection potential
- establish and maintain relationships with client representative(s) to resolve issues with processes and workflows
- ensure the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and follow federal, state and payer regulations
- obtain and increase revenue by resolving claim and technical issues; maintaining customer relations; resolving problems
- subscribe to all national payor bulletins, staying connected with industry changes and report to client, team, and technical analysts on impacts to workflows
- interface with customers and establish relationships that promote the timely and efficient resolution of transactions and other issues
- hire, develop, motivate, and coach a group of individuals dedicated to providing excellent customer service to all stakeholders
- manage billing staff, and provide continuous education, motivation, training, and leadership
- coach staff in problem solving, effective communication strategies, and conflict resolution and career path opportunities
- perform quality review of staff based on established metrics, and ensure staff has adequate information and training to perform assigned tasks
Requirements
- Certificate or equivalent relevant combination of education and experience
- High school diploma, GED, or a combination of relevant experience and some higher education is required
- Bachelor's or associate degree in business or relevant area of study preferred
- 5 years’ experience working in healthcare with at least two years of managerial or project leadership experience
- For PB billing focused positions, previous FQHC/RHC experience is preferred
- Coding experience or CPC - Certified Professional Coder helpful
- Experience with Acute Care EHR software, EPIC, is required, specifically expertise in HB Resolute module
- Experience with HB Claims, Prelude, Cadence and EpicCare modules preferred
- For HB focused positions, Critical Access Hospital or Method 2 Billing experience preferred
- Must be a self-motivated team player with significant experience in physician office or medical practice revenue cycle management including coding, charge capture, time of service collection, insurance eligibility and benefits verification, claims, submission and management and accounts receivable management, including familiarity with ICD-10, CPT, and/or HCPCS Coding Systems as well as claim forms such as CMS-1500 and UB-04
- Understand external rules and regulations as they relate to healthcare billing and collections e.g. Medicare, Medicaid, state laws, Health Insurance Portability and Accountability Act (HIPAA), etc.
- High level of research and root cause analysis and problem-solving capabilities, superior attention to detail.
- Extensive analytical skills and the ability to clearly communicate decisions, procedures, and processes to a diverse group of people.
- Demonstrate creativity and a willingness to change and adapt as needed.
- Follow up on assignments, show initiative, be self-motivated, and have a strong work ethic.
- Proven experience creating, analyzing, and explaining complex reports.
- Demonstrate independent judgment and self-sufficiency in effective problem solving.
- Commitment of time and energy.
- Willingness and ability to work overtime.
- Proficiency with standard office equipment and software such as Microsoft Office, specifically high aptitude in Microsoft Excel, proficiency in Power Point, and knowledge of VISIO.
- Proven ability to quickly master new applications.
- Knowledge of Medicare Billing Systems (DDE, Ability Ease) preferred, experience using payor portals required.
- Excellent communication skills, written, verbal, and listening, as well as demonstrated business writing skills, are required.
- Must be willing to travel to as necessary to accomplish departmental and organizational goals.
Benefits
- generous compensation package
- fostering a healthy work-life balance
- equitable opportunity for professional advancement
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