ICL

Program Billing Supervisor

US-NY-New York
Position Number
FD552502
Department
Finance Department
Type
Regular Full-Time
FLSA Status
Exempt
Minimum Salary
USD $50,000.00/Yr.
Maximum Salary
USD $50,000.00/Yr.

Overview

The Program Billing Supervisor will report to Director of Finance with dotted line to the SVP of Treatment and Recovery Division. This position is accountable to manage the day to day revenue cycle operations in order to maximize the collection of clinic services payments and reimbursements from patients, managed care insurance carriers, Medicaid and Medicare.   Oversee all program specific activities that are part of the revenue cycle. The incumbent will support clinic office managers, identified ambulatory care program billers and Program Assistants and operational staff and managers, and collaborate with both the Electronic Health Record (EHR) Team and Finance Department staff, in ensuring systems are in place to maximize collections to all third-party payers. The incumbent will also serve as a liaison to all managed care plans for operational staff as it relates to systems specific to authorizations, utilization management, denial management, and other related activities. He/she plays an important role in the company’s business growth by helping maximize revenue and bring to attention any issues regarding billing, accounting, business procedures or finances. These professionals serve as a point of contact within ICL Billing Department & Clinics and relay information to insurance companies, team members and other departments of the revenue policy and procedure.   He/she responsible coordinating all train staff members in new billing polices and collaborate with other staff regarding billing systems evaluations and improvements. The incumbent in this position will support the mission, vision, values and strategic initiatives of ICL and must demonstrate a commitment to quality services to patients, physicians, the public and co-workers.

Responsibilities

ESSENTIAL JOB FUNCTIONS:  List all essential job duties. (To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily with or without a reasonable accommodation. Reasonable accommodations may be made to enable qualified individuals with a disability to perform the essential duties unless this causes undue hardship to the agency.)

Managed Care Organization (MCO) Activities

  • MCO Liaison for all agency functions
    • Spearhead communication and system for authorizations, appeals, legal issues, reversals, site visits, credentialing, recredentialing, etc.
  • Site Visit(s) coordination for all plans
  • Credentialing liaison and form completion
  • Contract tracking and support for all agency functions; confirming which insurance products are covered in contract; understanding provider manuals of all plans
  • MCO Portal Point Person

Electronic Health Record (EHR) Liaison

  • EHR systems coordination - collaborate with Finance and EHR to ensure system is properly set up to submit and maximize billing for programs within Division; ensure operations staff are aware of how to use EHR on front end; ensure operational reports from EHR are available and properly used to submit timely billing.
  • Front end billing support person –point person for the EHR system-- Anasazi (AZ)       tickets, trend identification on operational opportunities for improvement, and necessary support/training in collaboration with AZ team to address operational issues.
  • Support EHR setup based upon contract structure.

Revenue Cycle Operations

  • Electronic Provider Assisted Claim Entry System,(ePACES) oversight/training/management
  • Denial Management – trend identification and training in collaboration with Finance to limit future denials
  • Tracking entitlements in outpatient programs such as PROS and ACT to ensure surplus patients are managed efficiently and Finance notified for back billing
  • Authorization process tracking and support
  • Continue to provide MCO training in all aspects related to billing
  • Ensure billing is submitted timely by admin support staff and ensure tickets are addressed
  • Ensure insurances are checked accurately and regularly

And other duties as may be assigned

Qualifications

ESSENTIAL KNOWLEDGE, SKILLS AND ABILITIES

  • Familiar with a variety of the field's concepts, practices, and procedures.
  • Excellent judgment and problem-solving skills
  • Ability to collaborate with a wide range of contacts and to secure their trust and cooperation
  • Fully conversant with electronic software and hardware and advanced Excel and other Microsoft Office Suite programs
  • Knowledge of Medicaid, Medicare and MCO regulations
  • High-level oral and written communication skills
  • Ability to meet deadlines and hold others accountable for meeting deadlines
  • Able to evaluate and improve systems
  • Daily travel from clinic to clinic is required

MINIMUM EDUCATION & EXPERIENCE REQUIREMENT

 

Bachelor’s degree required, Master’s degree preferred from accredited institutions of higher learning

At least 3 years of progressive experience in either program operations, medical billing, project management or experience with managed care organizations. Must have experience navigating complex programs and / or organizations

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