Claim Audit Billing Supervisor

4 weeks ago

Tempe, United States NextCare Full time
Job DescriptionJob Description

NextCare Introduction

NextCare strives to be the leader in high access healthcare, offering urgent care, occupational health, virtual health and primary care services to our patients. With offering services in twelve states (Arizona, Colorado, Kansas, Michigan, Missouri, New Mexico, Nebraska, North Carolina, Oklahoma, Texas, Virginia and Wyoming) and over 170 urgent care clinic locations, we offer exceptional, affordable care to patients across the country.

At NextCare, we constantly strive to provide you with the highest degree of caring, growth, integrity, results and teamwork. These essential core values form the foundation of our relationships with patients, customers, investors, partners and one another. Extraordinarily high-performance standards serve as critical guides for making important clinical and business decisions. The expression of these standards is evident in our behavior, our attitude, and our approach to our daily work. The product of our strict adherence to core values is the ability to harness tremendous organizational energy to achieve our goal of upholding the highest standard for quality and service within the high access healthcare. This unique combination of values, performance standards and commitment serves as the key to our success.

What we are looking for

NextCare Urgent Care is looking for a Claim Audit Billing Supervisor to be a part of our Urgent Care Team.

Location

To join our Billing team in Tempe, AZ - Hybrid/Remote. Must be located locally.

POSITION SUMMARY:
This position is responsible for managing the billing process for all patient visits to ensure all claims are billed in a compliant manner to all carriers. The Billing Supervisor is also responsible for the following: staffing, reviews, distribution of work assignments, dissemination of current billing guidelines, updating clinic insurance resources, reviewing patient medical records for accurate documentation, charge validation, and coordinating with the Coding Department as needed to ensure proper claim submission. This position will report to the Billing Manager and Sr. VP of Revenue Cycle and help identify issues and implement solutions to resolve billing errors prior to billing to the insurance carriers. Through their efforts, they will assist with decreasing the number of up front denials and prevent the A/R from aging.


ESSENTIAL FUNCTIONS:
• Responsible for the daily billing of claims to insurance carriers, patients, and employers based on contract requirements and payer guidelines to ensure compliance on all levels of the revenue cycle.
• Develop policies and procedures for the billing department and update as regulations change either globally or by state.
• Supervision of the Business Office Clerks, Billing Coordinators, Acquisition Billers, Coders, Eligibility, and Claim Auditors.
• Responsible for ensuring timely and effective billing for acquisitions, auditing and billing of existing clinic charges, and clearinghouse billing.
• Work with the Collections, Credentialing, and Cash Posting department on issues as it affects claim payments, denials, and short pays.
• Keep up to date on all billing and documentation changes in all states that NextCare operates in currently and any future locations
• Evaluate claim edits and monitor to ensure claims are “scrubbed” well before heading to the clearinghouse.
• Work with the Cash and Correspondence Manager to identify system issues up front that affect claim adjudication and payment processing.
• Assist with claim processing problems and troubleshoot system issues and errors as they occur and work with management on clean billing process
• As NextCare adds clinics and other states to the business assure that the billing department integrates these seamlessly into the coding/billing process.
• Job duties include but not limited to staffing, training, and general HR functions.
• Treats patients and co-workers consistent with the NextCare Mission Statement, Vision, Values and Performance Standards.
• Performs other related duties as assigned or described in Company policy.

Education: Minimum of High School Diploma or equivalent


Experience:
• Minimum two years of experience in A/R management, billing, collections, payment posting
• Minimum two years of team leader, managerial/supervision experience, basic insurance knowledge, reading patient eligibility and benefit coverage details.
• Experience with revenue cycle and reimbursement in a healthcare facility
• Microsoft Programs, Windows, Excel, Word, and Teams.
• Internet browser knowledge (basics) for Edge or Chrome.
Skills: Excellent verbal and written communication skills and be able to work independently

VALUED BUT NOT REQUIRED SKILLS AND EXPERIENCE:

• Nextgen PM / EHR
• Waystar Clearinghouse
• Payer Provider Portals
• Basic Terminology of Medical Billing Practices


REPORTING TO THIS POSITION: Yes

Benefits:

NextCare offers full time employees medical, health savings account, NextCare employee visit program, dental, vision, basic life, voluntary employee/spouse/child life, long term disability, short term disability, employee assistance program, critical illness, accident, legal, identity theft and paid time off benefits. Employees of all statuses are offered 401(k) Plan benefits. Employees in select positions are offered shift differential benefits. Benefits are offered per policy and plan rules.

NextCare Urgent Care is an Equal Opportunity Employer.

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