Bone and Joint Center, S.C.
  • 01-Mar-2019 to 30-Apr-2019 (CST)
  • Business Office
  • Wausau, WI, USA
  • Full Time

Summary:  Supervises and supports the daily operations of Revenue Cycle Staff for all related functions of coding, billing, accounts receivable, collections, and other related tasks and requests that may be necessary from time to time.  Ensures all patient encounters are accurate and billed in a timely manner, by the most efficient means possible and according to established policy.  Actively supports the Bone & Joint Leadership Mission and Vision Statement and the Bone & Joint Strategic Plan.  May be working out of our Merrill and/or our Schofield business office.

 

Essential Duties and Responsibilities include the following.  Other duties may be assigned.                                                                

 

  Quality:

  1. Supervise and oversee the accuracy and timeliness of billing as well as ensure payments are reimbursed according to contract.
  2. Maintain an Auditing process for billing, accounts follow-up, payment posting and other functions to monitor the quality and quantity of work performed by staff.
  3. Work with providers, clinical staff, coders, HIM on coding and documentation issues, along with payer guidelines to assist improving the quality of coding and documentation.
  4. Interfaces with the Revenue Cycle Analyst.
  5. Monitor end of month (EOM) processes to ensure minimum backlog for EOM processing, including coordination with providers, HIM, billers, coders, payment posters, and Finance Department to ensure all eligible charges are entered by the EOM cut-off date.
  6. Oversight on refunds, adjustments and write-offs to ensure that they are accurate, timely and within expected limits.  Work with management on variances and unique situations.
  7. Establish procedures, signing authority limits for write-offs and refunds.
  8. Assist management to establish checks and balances in the processes and online system to avoid potential risk to the practice.
  9. Understand the ANI network and our practice's direct contracts, as well as Medicare guidelines and respective reimbursement levels. Communicate changes to all necessary providers and staff.   
  10. Participate in development of department policies and procedures.

  People:

  1. Responsible to supervise the Coding and Patient Accounts leads, Billing Specialists, Insurance Specialists, Payment Posters, and Collections.
  2. Act as a key resource for questions related to the revenue cycle for all staff, management and providers.
  3. Interview, hire, schedule and train excellent staff, using Studer Quest for Excellence and other hiring techniques available to our hiring supervisors.
  4. Perform 30-, 60- and 90-day orientation reviews for new staff.
  5. Set schedules and work locations for staff to meet practice needs, and accommodate staff needs whenever possible.
  6. Coach staff and work to raise low performers to required standards and performance levels using Studer HML guidelines. Support retention of high performing staff.
  7. Provide annual performance evaluations to staff, meeting the practice guidelines for timely completion.
  8. Assess and establish disciplinary processes where indicated by staff performance.
  9. Cross-train all functions to ensure continuity of service in the event of leaves or other absences.
  10. Lead monthly staff meetings and/or weekly huddles to provide information, general updates, and policies and procedures to staff.
  11. Round on patients and employees monthly, meeting all monthly targets.
  12. Participate in inter-departmental meetings, projects and other needs as requested.

 

   Service:

  1. Analyze the Accounts Receivables Aging to determine payer trends and issues.
  2. Research and develop workflows collaboratively with department leads for ever-changing coding, insurance billing, collections, and accounts follow-up requirements.
  3. Assist staff and work to resolve payer issues which prevent our claims from being paid the first time they are submitted.
  4. Provide reports to management as required.
  5. Work with Registration and Verification of Benefits/ Precertification for accurate Patient demographics and insurance information that will ensure that the claims are billed correctly the first time.
  6. Assist with Patient complaints and/or service recovery efforts when they involve the Patient's charges and balance or whenever requested.
  7. Participate in and/or provide information or reports to the Board of Directors and the Administrative Team, as requested.

  Growth:                                                                                                

  1. Look for system tools and enhancements that will offer greater efficiencies and accuracy of every aspect of the revenue cycle, as well as helping management to assess the potential for reducing FTEs and/or reassigning staff.
  2. Assist management in planning and implementation for new services, service lines and/or locations.
  3. Raise expectations and results of performance for yourself and your staff through ongoing training, coaching, Studer Quest for Excellence and other staff development initiatives.
  4. Assist with development and participation with projects and other practice needs.

   Finance:                                                                                                          

  1. Review and have signatory responsibility for write-offs, adjustments and refunds as dictated per financial policy and procedures, reviewing discrepancies and/or unusual circumstances with management and administration.
  2. Achieve and maintain days outstanding in A/R according to the practice's chosen benchmark, such as MGMA standards.
  3. Maximize revenues by efficient workflows and assessing contractual to actual payments.
  4. Enhance revenues by assisting management with billing for new services and/or service lines.
  5. Assist management in preparing annual department budgets for staffing, expenses and capital equipment.
  6. Assist management in meeting financial goals and maintaining low budget-to-actual variance. 

 

 

Education/Experience

  1. 2-5 years' experience in medical billing, including insurance billing requirements.
  2. 2-5 years' experience working aged accounts receivables.
  3. 2-5 years' experience ICD 10 CM and CPT coding or coding knowledge needed to bill and work aged accounts.
  4. Knowledge and ability to work with commercial, Workers Compensation and government payers.
  5. 1+ years' Ambulatory Surgery Center billing and aged A/R experience preferred, including both CMS and UB claims requirements for ASCs.
  6. High level of research, analysis and problem-solving skills.
  7. Ability to work with the payers, the network, the Patients and staff throughout the organization at all levels.
  8. 2-5 years' experience working with payer contractual reimbursement levels.
  9. Post-secondary education in health business field preferred.

 

Qualifications:

  1. Minimum of 2 years' of supervisory experience in a health care related field required. 
  2. Medical billing and accounts receivables supervision in an orthopedic practice preferred.
  3. Experience with Centricity Practice Solution practice management system and HSTpathways helpful.
  4. Must have a valid driver's license and able to travel to all locations of Bone & Joint as needed.

 

Physical Demands:  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to stand; walk; sit; use hands to type; and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch and bend.  The employee must occasionally lift and/or move boxes up to 20 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

 

Essential Physical Requirements

 

     Mark all responses using the following codes:

            N  =   Never

            O  =   Occasional, represents 1 to 33% or 1 to 2 hours of an 8 hour workday.

            F   =   Frequently, represents 34 to 66% or 2 to 5 hours of an 8 hour workday.

            C  =   Continuously, represents 67 to 100% or 6 to 8 hours of an 8 hour workday.

 

PHYSICAL ACTIVITY

N

O

F

C

Walking

 

X

 

 

Standing

 

X

 

 

Sitting

 

 

 

X

Reaching Shoulder Height

 

X

 

 

Reaching Above Shoulder Height

 

X

 

 

Reaching Below Shoulder Height

 

X

 

 

Climbing

X

 

 

 

Pulling 25 Pounds or Less

X

 

 

 

Pulling 25 Pounds to 50 Pounds

X

 

 

 

Pulling Over 50 Pounds

X

 

 

 

Pushing 25 Pounds or Less

X

 

 

 

Pushing 25 to 50 Pounds

X

 

 

 

Pushing Over 50 Pounds

X

 

 

 

Lifting 25 Pounds or Less

X

 

 

 

Lifting 25 Pounds to 50 Pounds

X

 

 

 

Lifting Over 50 Pounds

X

 

 

 

Carrying 25 Pounds or Less

X

 

 

 

Carrying 25 Pounds to 50 Pounds

X

 

 

 

Carrying Over 50 Pounds

X

 

 

 

Crawling/Kneeling

X

 

 

 

Bending

 

X

 

 

Twisting/Turning

 

X

 

 

Balance

X

 

 

 

Repetitive Movement (fine motor like typing, writing, keyboarding, filing)

 

 

 

X

 

 

PHYSICAL EXPOSURE

 

Unprotected Heights

 

N/A

Lighting Bright

X

 

Lighting Dim

 

N/A

Mechanical Hazards

 

N/A

Hazardous Substance

 

N/A

Infectious Diseases

 

N/A

Harmful Physical Agents (Heat/Cold)

 

N/A

Noise

 

N/A

Ionizing/Non-Ionizing Radiation

 

N/A

 

 

 

PHYSICAL ABILITY

ACCEPTABLE MINIMUM

Vision

Good

X

Poor

 

Blind

 

Color Vision

Normal

 

Impaired

X

 

Hearing

Normal

X

Moderate Loss

 

Deaf

 

Manual Dexterity

Good

X

Fair

 

Poor

 

Talking/Speech

Good

X

Fair

 

Mute

 

 

*Note It is the Bone & Joint Clinic policy not lift, pull/push, carry 50/50+ lbs. without assistance

 

Bone and Joint Center, S.C.
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