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Job Opening: Supervisor of Insurance

SUMMARY OF JOB:
Responsible for timely and accurate medical claim submission to responsible payers. Responsible for monitoring and development of Business Office medical insurance staff. Ensures compliance with Medicare and Commercial Insurances and Federal and State Laws impacting health care. Monitors and creates edits in the electronic billing system to achieve accurate high clean claim ratios. Coordinates office efforts and works closely with physician staff.

DUTIES AND RESPONSIBILITIES:

  • Provides support and guidance to medical insurance staff and other direct reports.
  • Organizes and manages the workloads of staff as well as assigning any work of open positions.
  • Files, re-files, researches and appeals outstanding medical insurance claims.
  • Monitors billing processes of billing staff to assure that billing is correct and timely.
  • Processes or facilitates and oversees processing of all insurance claims.
  • Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied billings. Determines the accuracy of charge capture, missing charges, late charges, covered and non-covered charges.
  • Receives, reviews and distributes printed pertinent material to appropriate personnel.
  • Escalates issues with payers and reports improvement as appropriate.
  • Serves as a resource to staff by answering questions, assisting with problems, and providing training as necessary.
  • Monitors all Encoda exceptions and takes necessary actions when needed.
  • Is responsible for work schedules, approving work hours and ensuring good attendance records of staff members. Must maintain a good personal attendance record. (See attached attendance and punctuality requirements.)
  • Attends all monthly/quarterly payer meetings onsite and any offsite as needed.
  • Establishes and maintains effective working relationships with employees, supervisors, patients, customers and the public. Exemplifies the Company’s Five Star Program.
  • Follows all corporate and departmental policies and procedures and complies with the Employee Handbook.
  • Must be capable of performing all tasks required insurance clerks.
  • Uses a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings
  • Establishes and maintains effective working relationships with supervisors, employees, patients, customers and the public.
  • Exemplifies the Company’s Five Star Program.
  • Follows all corporate and departmental policies and procedures and complies with the Employee Handbook.
  • Performs other tasks as needed or directed.

PERFORMANCE REQUIREMENTS:

  • Must be a graduate of an accredited high school.
  • Requires at least 5 years of work experience in the field of medical insurance reimbursement.
  • Must have good manual dexterity for operating office equipment. Must be able to function in an office setting.
  • Must be able to transcribe information received from insurance offices and patients without error.
  • Physical activity involves typing, writing, reaching, carrying, looking, listening, talking, bending, lifting, standing, walking, and much sitting, resulting in light work.
  • Must be able to lift or carry up to 10 pounds of weight up to 10 feet occasionally (up to 1/3 of the time), or a negligible amount of weight up to 10 feet frequently (from 1/3 to 2/3 of the time).
  • Light work requires sitting most of the time, but may involve periods of standing and walking depending on task requirements.
  • Works in an office setting, which is well-lighted, ventilated and temperature regulated. Automobile travel is required.
  • Must be able to concentrate on work tasks amidst distractions, such as noise, conversations and foot traffic.
  • Must be able to work in a confined area performing repetitive work for extended periods of time.
  • Must have responsible, ethical and professional manner with the ability to listen, learn, plan and organize. Must be able to communicate with people of different races, sexes, ages and social classes.

The statements listed above describe the principal functions of the job and should not be considered as a detailed description of all the work requirements that are inherent in the position. To perform this job successfully an individual must be able to perform the essential duties and performance requirements satisfactorily. Reasonable accommodations will be made for individuals who are able to perform the essential functions of the job.

Posted June 28, 2024

    APPLICATION FOR EMPLOYMENT

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    Required Section

    Read this section carefully. Your signature certifies to these procedures.

    This application will remain active for 30 days. I understand that to be considered for employment after that time, I must complete a new application form.

    I certify that information given by me is true and correct. I understand that falsification or omission of any information on this form or in a personal interview may result in my termination, whenever discovered by the Company. I authorize the Company to make such investigations of my employment, financial, medical and other history as it deems necessary. I also authorize my past and present employers, schools and all other persons to respond fully to any such inquiries from the Company, and I release all such persons from any liability in responding to such inquiries.

    I understand that I may be subject to a pre-employment medical screening, after receiving a conditional offer of employment, and must meet the qualifications for the positon, with or without accommodation, before being permitted to commence work. I understand employment is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

    If employed, I agree to abide by all rules, policies and procedures of the Company. I understand and agree that, if employed, my employment is at-will, for no definite or permanent duration, and may be terminated by either me or the Company at any time without notice or cause. I understand that no one has any authority to change these terms of my employment, or to make any contrary agreement with or promises to me, except in writing by the Chief Executive Officer.

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    WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Federal laws and regulations prohibit discrimination in employment practices based on age, race, religion, sex, national origin, military status, disability or sexual preference.

    Premier Medical Group, Inc complies with the American with Disabilities Act and offers reasonable accommodations to all qualified persons with disabilities.