To oversee all billing operations for consistency, propriety, and compliance with external regulations and internal policies and procedures. Oversee applying payments and adjustments from various payers, including government and commercial. Oversee reconciling payments received by KPNW facilities and bank lockboxes. Oversee manual charge entry.
Essential Functions:
- Supervise Billing, Payment Posting and Charge entry Supervisors, coordinate training and establish, approve and maintain the Policy and Procedures for the department.
- Ensures staff organization to promote efficiency, accountability and appropriate segregation of duties.
- Establish and maintain quality and production standards for the department.
- Write and implement Patient Financial Services (PFS) policies to support compliant billing, accurate accounting, timely payment posting and charge entry to ensure appropriate reimbursement.
- Develop tools to provide appropriate information to General Accounting and revenue-producing departments, including feedback to service providers.
- Monitor and maintain the billing dashboard established baselines.
- Leads continuous improvement in billing compliance, identifies and investigates system vulnerabilities which may impact compliance with billing rules, payment posting and charge entry rules ensures appropriate corrective action.
- Strives to eliminate variation in the process outcome.
- Represents PFS at cross-departmental meetings regarding compliance, billing, payment posting, charge entry.
- Works closely with various business partners to ensure collaborative, productive working relationships between departments.
Qualifications:
Basic Qualifications:
- Five (5) years of supervisor experience.
- Five (5) years of medical/provider or hospital billing office experience.
- Experience identifying and resolving compliance issues.
- Experience identifying and resolving billing issues.
- Experience identifying and resolving payment posting issues.
- Experience identifying and resolving charge entry issues.
- Bachelor's degree in accounting, economics, health care administration, or other related field of study or equivalent.
- Member HFMA or HCCA preferred.
- Ability to read, research, analyze, and reach accurate conclusions from complex regulations, technical specifications, accounting reports, and statistics.
- Detailed knowledge of billing processes, payment posting processes and charge entry processes.
- Close familiarity with regulations applicable to health care claims submitted to Medicare, Medicaid, and all other payers including internal KP claims processing.
- Knowledge of government agencies which formulate billing rules, interplay between state and federal regulations in regard to health care billing.
- ICD-9 (10), CPT-4 coding rules and processes pertinent to billing for services.
- Proficient in Microsoft office (Excel, Word, etc.).
Preferred Qualifications:
- Experience in EPIC health care information systems, particularly billing, payment posting and charge entry preferred.
- Certified Professional Coder, RHIT, CPAM, or other professional association accreditation pertinent to job duties is preferred.
- Knowledge of the regulatory compliance principles in health care billing, payment posting and charge entry preferred.
- Knowledge of medical office, hospital, and/or hospice operations preferred.
- Excellent verbal and written communication skills preferred.
- Excellent time management, personnel management, and organizational skills preferred.
- Compliance auditing background in professional or hospital billing environment preferred.
Salary Range:
$73,540 - $100,660
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.