Insurance Reimbursement Supervisor

4 weeks ago

Seattle, Washington, United States Neighborcare Health Full time

SUMMARY:
The Insurance Reimbursement Supervisor works alongside the Insurance Reimbursement and Patient Financial Specialist.

They will work with the team to ensure the collection of and to maximize revenue opportunities through daily/regular oversight of the team by ensuring consistent follow-up and/or appeal of unpaid, partially paid or denied claims.

They will also work alongside the Director of Revenue to effectively monitor and report on billing metrics and strategic revenue opportunities.

They will work alongside the EPIC Specialist Team and Director of Revenue to build revenue rules for an improved billing process.

They will monitor collection and accounting of payer revenues including but not limited to the billing of all claims, collections and follow-up on existing accounts receivables.

Neighborcare Health offers a robust benefit package including Health, Wellness & Retirement benefits: Medical, Dental & Vision Insurance, 18+ days of Paid Time Off, 9-Paid Holidays, Retirement with Matching, Life & AD&D, Pet Insurance, Employee Assistance Program, & More This position is eligible for the Staff Referral Program

KEY RESPONSIBILITIES:
Supervise and mentor the Insurance Reimbursement and Patient Financial Specialist Teams

Accurately decipher denial reason and prospectively plans follow-up steps utilizing the electronic billing system
Collection efforts for primary, secondary, or tertiary Insurances, which include calling commercial and government insurance companies
Provide oversight at all levels of an insurance appeal
Provide training, guidance and direction to direct reports
Monitor and review Aged A/R
Review and process Write Off Requests
Monitor Productivity Reports
Partner with Director of Revenue and internal departments to resolve business issues that may affect collection activities
Responsible for ensuring that all payer correspondence is distributed and handled in a timely manner.
Review managed care contracts to determine correct reimbursement for each account
Submit written appeals for underpayments to insurance companies
Tracks, recognize trends and analyzes ways to fix/reduce payer denials and rejections.
Call insurance companies to check on the status of unpaid claims
Works on and tracks outgoing and incoming correspondence from insurance companies
Understands and follows all federal, state, and local payer-billing requirements.
Print and re-file claims as needed
Answer incoming patient and insurance company phone calls as received
Ensure all accounts are worked from work queues with proficiency and 95% accuracy
Assist the team to meet individual quality and quantity performance goals
Make independent decisions that require individual and/or team analysis, reasoning, and problem solving.
Knowledge and understanding of the healthcare revenue cycle
Knowledge and understanding of CPT4, ICD10 and HCPC coding
Understanding and knowledge of insurance plans pertaining to contractual adjustments and discounts
Excellent customer service skills
Perform other duties as assigned

SUPERVISORY:
Develop effective and efficient staffing schedules that are sensitive to productivity, workflow requirements
Audit operational processes and counsel/train staff as needed.
Supports staff efforts in the resolution of customer service and billing issues
Recommends and implements changes to Billing Coding policies and procedures as necessary.
Performs regular review of regulations governing the billing of patient services and organizational billing practices.

KEY SKILLS:
Ability to adhere to Neighborcare Health policy and procedures
Ability to be detail oriented and to problem-solving
Research Insurance Denials
Ability to interpret and discuss an insurance explanation of benefits and payments
Ability to meet and comply with HIPAA/Confidentiality policies and procedures
Ability to organize, problem solve, and work under pressure independently to meet critical deadlines
Ability to demonstrate predictable, reliable and timely attendance
Knowledge of Managed Care, Medicare and Medicaid guidelines
Extensive working knowledge of billing and collections for Medicare, Medicaid and commercial payers.
Skill in time management
Basic Accounting Skills
Basic knowledge in Microsoft Word and Excel
Strong attention to detail
Knowledge and understanding of policies and procedures governing credit balance analysis and resolution of provider contracts with insurance companies

EDUCATION/

EXPERIENCE:

Required:
Associate's Degree,2-3 years of medical billing/collections,1-3 years lead or supervisory experience in healthcare


Our Mission The mission of Neighborcare Health is to provide comprehensive health care to families and individuals who have difficulty accessing care; respond with sensitivity to the needs of our culturally diverse patients; and advocate and work with others to improve the overall health status of the communities we serve.

About our Service Commitments Our service commitments were created by staff members, leaders, board members and patients. We use these as a guide and expectation for how we treat our patients and each other. You may learn more about our service commitments here,

Serving patients
Serving each other
A warm welcome
Caring
Respect
Working together
Trusting Relationship


About us For 50 years, Neighborcare Health has been caring for our neighbors with essential medical and dental care, counseling, outreach, health education and more in Seattle, Vashon, and our newest dental clinic in Olympia Our purpose is to improve health by engaging, educating, and empowering people in the communities we serve.

We are looking to hire the best talent to support our culturally diverse workplace and community.

Compensation

The wage range for this position is minimum $53,444.00 up to $70,869.72 maximum.
Compensation will be determined based on years of relevant experience.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities


The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.

41 CFR c)
#J-18808-Ljbffr

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