Patient Accounts Supervisor, Hospital (HB) Claims Follow-up and Denials Management
Location: Southern Pines, North Carolina
Facility: 10 - MRH/Corporate
Department: BUSINESS OFFICE
Schedule: Full Time: 40 hrs/wk
Shift: Day Shift
Hours: M-F 8a-5p - hours may vary to meet the needs of the department
Job ID: 2025-17489
Overview
We are seeking a dedicated and experienced professional to direct and coordinate the accounts receivable responsibilities of the Hospital (HB) claims follow-up team for the organization . In this role, you will have the opportunity to design, plan, and implement cutting-edge technology and processes to elevate our Revenue Cycle Management operations. As a key player, you will assist in resolving complex accounts receivable issues and be an interictal member of the RCM team. If you have a passion for continuous improvement and possess strong leadership skills, this is the position for you!
Responsibilities
- Direct and coordinate the follow-up and balance resolution efforts for outstanding accounts receivable under area of responsibility.
- Design, plan, and implement new technology and processes to improve hospital claims follow-up and denials operations.
- Supervise personnel directly responsible for resolving outstanding hospital claims.
- Assist employees in resolving outstanding claims issues, to prevent and/or work denials and allow for expected reimbursement.
- Review A/R reports and coordinate productivity of appropriate personnel to resolve outstanding claims and reduce denials.
- Actively participate in the implementation and maintenance of claim systems and pre-bill editing processes, as well as collaborating with IT/EPIC resources on system and operational enhancements.
- Work collaboratively with clinical department directors to share data and create effective workflow to positively impact AR management.
- Review payor websites for bulletins, transmittals, program memorandums, payor specific medical review policies, and other billing and reimbursement information.
- Educate and distribute relevant information to appropriate staff.
- Provide services with consideration of the recipient's needs.
- Collaborate with other RCM leaders to improve operational flow and employee satisfaction.
- Work with management to solve problems, enhance productivity, and handle special situations.
- Assist with patient complaints related to claims/billing issues.
- Assist other departments with billing problems.
- Assist with new system upgrades, changes, and testing.
Qualifications
- High School graduate plus two years' additional education in accounting or business administration, or equivalent work experience.
- Minimum of five years' experience in similar healthcare Revenue Cycle Management role, preferred.
- Strong interpersonal and verbal communication skills.
- Ability to manage multiple tasks in an organized manner.
- Excellent analytical and problem-solving skills.
- Leadership skills with the ability to reach consensus.
- Demonstrated strong computer skills. EPIC experience, preferred.
- Knowledge of CPT-4, HCPCs, UB-04, and ICD-10 Coding, as well as various payor guidelines and requirements.
- Ability to work independently, exercising sound judgment, discretion, and initiative.
Join our team and make a meaningful impact on our Revenue Cycle Management operations!
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