Job Description
Job Purpose:
Responsible for monitoring quality of work for all Full Cycle Billing Specialists and providing feedback to Billing Supervisors. Manage Medicaid encounter errors and identify Smartcare claims errors. Maintain full cycle billing responsibility for a reduced client load, ensuring all services receive maximum reimbursement through proper billing, eligibility and operations. Provide backup as needed to Full Cycle Billing Representatives and Credentialing Representative.
Duties and Responsibilities:
- Review and document all team correspondence to ensure accuracy of work and report issues to Management.
- Ensure all claims are in proper coverage plans to maximize encounters sent.
- Monitor all denial and errors trends to increase reimbursement and recommend corrective actions.
- Maintain full cycle billing responsibility for a reduced client load to ensure ongoing experience of accounts receivable.
- Monitor and Correct Claim Generation Errors
- Responsible to train and audit new hires and existing staff as needed.
- Identify issues in a timely manner to reduce denials and write offs.
- Special billing and projects as needed.
- Review and correct Encounter errors.
- Identify issues caused by incorrect Smartcare set up or changes and report to Management.
- Follow all AllHealth Network policies and procedures
- Complete all required trainings as listed in Relias Learning (both online training and face-to-face training) within required timelines
- Perform other duties as required within the scope of the position, experience, education, and ability of the employee.
- Responsible small AR assignments to work
- Other duties within the scope of the position and abilities of the individual, as assigned by the supervisor.
Key Technical Skills and Knowledge:
Education
High school diploma/GED
Experience
Full cycle reimbursement experience. Minimum of 2 years of related experience, including use of computers (Word, Excel, Outlook).
Minimum of 2 years experience with Electronic Health Record systems and claims clearinghouses.
Skills/Knowledge
10-key adding machine by touch
Posting and reconciling account ledgers
Ability to read and interpret explanation of benefits.
Interact with clinical staff and clients to ensure accuracy of clients accounts.
Effective verbal and written communication.
Maintain good working relationships with other employees, clients, other agencies and general public.
Attendance and active participation at all team meetings.