Duties and Responsibilities:
· On a daily basis, supervises assigned personnel;
o Staff will include front and middle office personnel, inclusive of patient intake and Medical Assistants/Student staff in the following departments: Scheduling, Registration, Eligibility, Authorizations, and Patient transport.
o Creates and monitors providers schedules to coincide with both on-site and telemedicine visits for all patient types (new visit, established patient, annual physical, etc.)
o Provides coverage to front and middle office as needed.
· Works as liaison between medical office and outsourced billing vendor
o Responsibility to conduct bi-monthly meetings with staff and billing vendor (issues, updates, coding changes, etc)
o Responsibility to work with vendor on routine claim rejections, denials, and unbilled inventory
§ Prioritizes accounts by age and expedites responses
o Prioritizes interaction between front desk, clinical staff and outsourced billing vendor to ensure timely delivery of required data for billing submission
o Provides proactive response and remediation to ongoing billing rejections, denials, and unbilled inventory
o Maintains and updates a list of in-network and out-of-network insurance carriers
· Performs ongoing monitoring and auditing of supervised staff areas to ensure accurate processes and information is being followed/recorded
· Development and management of projects and workflow reengineering
· Managing all phone calls and call productivity tracking. Ensuring dropped calls are minimized.
· Reconciles employee time sheets and maintains leave records. Prepares payroll for employees and physicians. Approve time off requests, track employee call outs, ensure all staff punches are correct for payroll and manage staff schedules.
· Oversees facility and daily facility issues (example: replacing lightbulbs, air conditioning functionality, etc.
· Assist with maintaining provider applications and credentialing information for participating health plans & hospitals through interaction with outsourced credentialing vendor
· Participates in professional development efforts to ensure currency in health care practices and trends.
· Must be able to hit all key performance indicators (KPI’s) created for the areas of responsibility, initiate corrective actions and achieve financial objectives set forth by the Director.
· Partner with Physician Ownership to plan and participate in committee meetings and manager’s meetings to achieve goals and initiatives.
· Identify possible threats to current and future business by identifying current issues and building operational plan to defend
· Performs other related duties as directed or required.
· Maintains patient confidentiality.
· Must be available to work two (2) evenings a week.
· Any other duties assigned by Director.
Knowledge, Skills and Abilities:
· Knowledge of practice policies and procedures.
· Knowledge of medical terminology and insurance practices.
· Knowledge of computer programs and applications.
· Knowledge of grammar, spelling and punctuation to communicate in written format.
· Knowledge of CPT and ICD-10 coding.
· Knowledge of managed care, Medicare, and Medicaid guidelines.
· Skill in effective personnel management including training staff and delegating duties.
· Skill in trouble-shooting insurance problems and appealing claims.
· Skill in maximizing insurance collections.
· Skill in written and verbal communication
· Ability to work effectively as a team member with physicians and other staff.
· Ability to flexibly respond to changing demands.
· Ability to plan, organize, prioritize and direct the work of others.
· Ability to identify claims problems and recommend solutions.
· Ability to sort and file materials correctly by alphabetic or numeric systems.
· Ability to interpret and understand insurance benefits and reimbursement.
· Ability to communicate clearly and concisely.
· Ability to establish and maintain effective working relationships with patients, employees, and the public.
· Experience with AMS system a plus