Description

Essential Duties and Responsibilities:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

• Performs a variety of systems administration and support tasks.
• Responsible for designing, implementing, and enforcing policies and procedures.
• Responsible for directing, leading, and coordinating the overall functions for the 20 plus person medical authorizations, billers, intake, and post-acute departments.
• Streamlining effective authorizations, billers, intake, and post-acute processes.
• Serves as the practice expert for all authorizations, billers, intake, and post-acute processes.
• Oversees the operations of the authorization, billers, intake, and post-acute departments, including charge entry, referral intake and insurance verification.
• Supervises office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
• Audits current procedures to monitor and improve efficiency of Authorizations, Billers, Intake, and Post-Acute operations.
• Provides, oversees, and/or coordinates the provision of training for new and existing billing, authorization, intake, and post-acute staff on applicable operating policies, protocols, systems and procedures, standards, and techniques.
• Coordinates team members request for any time away from work in a manner that does not negatively impact necessary daily functions.
• Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
• Ensures that the activities of the Authorization, Billing, Intake, and Post-Acute operations are conducted in a manner that is consistent with overall department protocol, and in compliance with Federal, State, and payer regulations, guidelines, and requirements
• Holds bi-weekly staff meetings for authorizations, billers, intake, and post-acute to ensure proper team building and protocol.
• Reports all concerns or issues directly to Intake Supervisor and Intake Manager.

Qualifications

• High School Diploma or equivalent
• One (1) to two (2) years working for a Durable Medical Equipment company or relevant medical office experience preferred.
• Basic understandings of medical insurance benefits
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
• Effectively communicate with physicians, patients, insurers, colleagues, and staff
• Able to read and understand medical documentation effectively.
• Knowledge and understanding of same and similar DME equipment.
• Knowledge and understanding of In-network vs Out of Network, PPO, HMO
• Thorough understanding and maintaining of medical insurances company's regulations and requirements to include but not limited to Medicare and Medicaid.
• Working knowledge of CPT, HCPCS & ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Learns and maintains knowledge of current patient database & billing system.
• Up to date with health information technologies and applications
• Answers telephone in a polite and professional manner. Communicates information to appropriate personnel and management in a timely manner.
• Establishes and maintains effective communication and good working relationships with co-workers, patients, organizations, and the public.
• Proficient in Microsoft Office, including Outlook, Word, and Excel
• Utilizes initiative, strives to maintain steady level of productivity and is self-motivated.

Access to Protected Health Information (PHI)

This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation. Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.

Schedule & Compliance

• MondayFriday shifts between 7:00 AM and 7:00 PM. (specific shift to be agreed upon)
• Occasional weekend work, overtime, or on-call rotation may be required.
• Strict adherence to HIPAA Privacy Rules when handling PHI.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

PI284918424