INTAKE/BILLING SUPERVISOR

JOB SUMMARY:

The Intake/Billing Supervisor will supervise MHIP intake and billing staff to ensure that all phases of intake occur. These phases include but are not limited to benefits verification, authorization, collections, accounts receivable, account payable, and patient financial counseling. The Supervisor will also ensure that the interaction needed with Caregivers, Physicians, and other internal/external stakeholders occurs during the execution of these functions. This individual must be knowledgeable of proper billing policies and procedures for all payors to ensure correct billing of claims and is responsible for medical billing and collections. This person will work under the direct supervision of the Pharmacy Manager and will collaborate with the healthcare team to provide exceptional value to our customers. This individual will be a key contributor and should be an experienced professional in this segment of care delivery. The successful candidate will supervise and be able to perform all duties in accordance with company policy/procedure, state professional standards, and other applicable regulatory requirements.

GENERAL REQUIREMENTS:

• Performs all job responsibilities in alignment with the mission and vision of the organization.
• Performs other duties as required and completes all job functions as per departmental policies and procedures.
• Maintains current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
• Wears protective clothing and equipment as appropriate.

GENERAL SKILLS:

• Ability to communicate in English, both verbally and in writing.
• Additional languages preferred.
• Strong written and verbal skills.
• Basic Computer Skills

WORKING CONDITIONS:

• General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
• May be exposed to high noise levels and bright lights.
• May be exposed to limited hazardous substances or body fluids, or infectious organisms.
• May be required to change from one task to another or different nature without loss of efficiency or composure.
• Periods of high stress and fluctuating workloads may occur.
• May be scheduled as needed including overtime.

PHYSICAL REQUIRMENTS & DEMANDS:

• Have near normal hearing: Hear alarms/telephone/normal speaking voice.
• Have near normal vision: Clarity of vision (both near and far), ability to distinguish colors.
• Have good manual dexterity.
• Have good eye-hand foot coordination.
• Ability to perform repetitive tasks/motion.
• Continuously within shift (67-100%): Standing, Walking.
• Frequently within shift (34-66%): Bending/Stooping, Pushing/Pulling, Lift/carry up to 20lbs, Lift/carry > 20 lbs. with assistance.
• Occasionally within shift (1-33%): Sitting, Climbing, Twist at waist, Lift/Carry > 50 lbs. with assistance, Reaching above shoulder.

MISSION STATEMENT:

QUALITY HEALTHCARE: In our continuing effort to enhance the quality of life for the communities we serve, the Hospital Authority of Miller County is committed to the delivery of superior, safe, cost-effective healthcare through the provisions of education prevention, diagnosis and treatment.

JOB SPECIFIC COMPETENCIES:

• Must be experienced with insurance coverage for infusion, specific health plans, and have familiarity with key requirements necessary for accurate benefit checks and authorizations.
• Able to accurately identify guidelines, coverage rules, and obtain prior authorization as well as certificates of medical necessity when needed.
• Responsible for medical billing and collections.
• Ability to research proper billing policies and procedures for all payors.
• Researches all denials and completes all corrections, resubmissions, and adjustments accurately and timely.
• Verifies all payments are received and are correct.
• Ensures that all claims are processed correctly against billing and industry standards and regulations and match our contract agreements with individual providers.
• Follows up on reimbursement communication and appeals when necessary in an efficient and timely manner.
• Have experience with Pharmacy management software for infusion
• Clearly, accurately, and concisely documents notes in medical software.
• Effectively communicates to manager and team when assistance is needed.
• Ability to maintain accurate and complete records.
• Communicates and resolves problems with patient/customer, physicians’ offices, referral sources, third party insurance companies, Medicaid and Medicare.
• Proven track record and ability to work with reporting to follow up on prior authorizations.
• Ability to assess what is needed and work effectively with all members of the Infusion Team including Pharmacists, Nurses, IV Pharmacy Technician, and Drivers to accomplish goal.
• Team player willing to assist with office duties like filing, putting together charts and other duties as assigned.
• Assists with answering and directing phone calls.
• Ability to work effectively with revenue team to maximize billing and collection of insurance claim receivables.
• Desire to educate themselves on the scope of services that are available through company and understand basic drug terminology and therapies/services provided.
• Actively support company mission, organizational/departmental policies and procedures
• Presents a professional appearance & approach w/member & other employees; demonstrates honest & ethical behavior. Handles member & employee info w/appropriate sensitivity & safeguards to ensure confidentiality & right to privacy, in compliance w/HIPAA regulatory requirements
• Contributes to the effectiveness of the team by working together by supporting, promoting & applying the best practice standards of conduct including those on attendance, mutual respect & support, honoring diversity, effective communication, & improving the work environment
• Exhibits flexibility when work assignments need to be adjusted to meet service, delivery and workload needs of team
• Takes initiative to identify, develop & adapt new policies and practices to improve quality of work
• Performs other related duties as assigned by management
• Excellent Communication skills including reading, writing, and speaking to effectively handle position responsibilities
• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction
• Computer skills and knowledge of how to enter and access data. Knowledge of Excel, Internet and Word Processing.
• Understand how to calculate and check for correct doses of medication.
• Ability to calculate figures and amounts such as discounts, interest, and percentages.
• Must demonstrate strong attention to detail.
• Possess ability to prioritize, perform multiple tasks at one time, and have good organizational skills.
• Work under stress effectively.
• Maintain confidentiality of patient and proprietary information at all times
• Observe legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary company information
• Understand and comply with HIPAA
• For all activities complies with accreditation, legal, regulatory, government and safety requirements

PROFESSIONAL REQUIREMENTS:

• Follows Code of Conduct policy.
• Adheres to dress code; appearance is neat and clean.
• Completes annual educational requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled; completes work within designated time.
• Wears identification when on duty; uses computerized time clock system correctly.
• Completes in-services and returns in a timely fashion.
• Attends annual review and/or skills fair and department in-services, as scheduled.
• Attempts to end conversations and other interactions in a positive manner; leaves others with a good impression of the Hospital Authority of Miller County and its employees.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission statement of the organization.

GUEST RELATIONS STANDARDS:

(All guest relation violations are subject to disciplinary action up to and including termination):

• Always treat others in a friendly, helpful manner.
• Refers co-workers to proper sources when unable to provide an answer.
• Interacts with others in a professional and friendly manner.
• Takes interest in others and always gives full cooperation to fellow workers.
• Always maintains an open line of communication with other departments.
• Thoroughly familiar with the hospital and the services it offers.

OTHER:

• Responsibility to Report: It is the responsibility of every employee of HAMC to comply with federal, state and local laws and regulations, as well as, HAMC Policies and Procedures. Every employee is help accountable to participate in, comply with and report concerns to his or her supervisor or the Compliance Officer if illegal or unethical behavior is suspected.
• As an employee of HAMC, you have been granted user access to applicable ePHI systems based on your position. This user or role-based access is intended to give you the minimum necessary access to perform your job function(s) only and should be used only as applicable.

OTHER DUITIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

EDUCATION, CREDENTIALS & EXPERIENCE REQUIREMENTS:

• High School diploma or equivalent. College degree is preferred.
• 5 plus years’ experience in Billing and Intake is required.
• Experience working in an acute or specialty infusion pharmacy is required.
• Experience working in a hospital infusion pharmacy is required.
• Experience with sterile compounding is preferred.
• Experience with CPR or CareTend Pharmacy Management System preferred.