• Oversee and streamline inpatient and outpatient billing processes & responsible for all related correspondence (Internal and external)
• Leads and provides training, awareness, application, update, policy management related to outpatient billing team and promotes a culture and environment that focus on accurate billing and timely submission of claims.
• Demonstrates an interest and an understanding of issues relevant to his/her department and the organization and keep his/her knowledge up to date
• Communicates effectively to ensure effective hand-over between shifts & schedules to cover 7 days a week.
• Manages inpatient and outpatient billing and claims for accuracy, completeness, follow up for timely submission and compliance with CHI and payer regulations, guidelines and requirements
• Supervise statement generation process for Outpatient and Inpatient claims.
• Proven track record for improving process efficiencies and solving problems
• Supports the team through conflict resolution, effective time management, workload prioritization and individual staff development.
• Audit insurance OP & IP claims and medical records to ensure that they are complete, accurate, and appropriate for billing
• Observes behaviors of employees and provides feedback to individuals and/or managers.
• Generate, analyze and/or managing daily, weekly and monthly reporting, identifying trends impacting charges, recommend denials and collections for process improvements, identifying training needs and recommending process changes
• Maintaining relationship with insurance companies to ensure that all claims are processed accurately
• Adhere to all practice policies related to CHI & NPHIES
• Follow up and escalates daily complains to the billing director if required and follow up to reach a satisfactory closure within the approved KPIs.
• Demonstrates compassionate communication skills while providing support and care to the patients as “the patient is the center of our care”.
• Education: BS degree in accounting, Qualified Accountant (ACA, ACCA or CIMA) or equivalent accounting professional certificate is a plus
• Experience: 5-7 Years of relevant experience
• Language: Excellent command of oral and written English
• Required Licenses: SOCPA
