Insurance Reimbursement Supervisor - Georgetown (1.0 FTE)

Purpose:

The Insurance Reimbursement Supervisor works alongside the Insurance Reimbursement and Cash Application Teams. The Insurance Reimbursement Supervisor will work with the team to ensure the collection of and to maximize revenue opportunities through daily/regular oversight of the Insurance Reimbursement by ensuring consistent follow-up and/or appeal of unpaid, partially paid or denied claims. The Insurance Reimbursement Supervisor will work alongside the Director of Revenue to effectively monitor and review revenue opportunities. The Insurance Reimbursement Supervisor will monitor collection and accounting of payer revenues including but not limited to the billing of all claims, collections and follow-up on existing accounts receivables.

• Supervise and mentor the Insurance Reimbursement Team and Cash Application Team
• Accurately decipher denial reason and prospectively plans follow-up steps utilizing the electronic billing system
• Collection efforts for primary, secondary, or tertiary Insurances, which include calling commercial and government insurance companies
• Provide oversight at all levels of an insurance appeal
• Provide training, guidance and direction to direct reports
• Monitor and review Aged A/R
• Responsible for ensuring that all payer correspondence is distributed and handled in a timely manner
• Submit written appeals for underpayments to insurance companies
• Tracks, recognizes trends and analyzes ways to fix/reduce payer denials and rejections
• Call insurance companies to check on the status of unpaid claims
• Works on and tracks outgoing and incoming correspondence from insurance companies
• Understands and follows all federal, state, and local payer-billing requirements
• Perform other duties as assigned

• Associate’s degree or relevant work experience

• Revenue Cycle Specialist Certification (AAHAM)/AAPC Billing Course Dental Billing Certificate via AAPC within a year of employment

• 2-3 years appealing denied or unpaid claims experience

• 2-3 years of medical billing/collections experience

• Bachelor’s degree desired or equivalent training and/or equivalent experience in patient accounting.
• 3-5 years of healthcare collections/billing experience
• 1-3 years of lead or supervisory experience 

• Develop effective and efficient staffing schedules that are sensitive to productivity, workflow requirements
• Audit operational processes and counsel/train staff as needed
• Supports staff efforts in the resolution of customer service and billing issues
• Recommends and implements changes to Billing policies and procedures as necessary

• Ability to adhere to Neighborcare Health policy and procedures
• Ability to be detail oriented and to problem-solving
• Ability to interpret and discuss an insurance explanation of benefits and payments
• Ability to meet and comply with HIPAA/Confidentiality policies and procedures
• Ability to organize, problem solve, and work under pressure independently to meet critical deadlines
• Ability to demonstrate predictable, reliable and timely attendance
• Knowledge of Managed Care, Medicare and Medicaid guidelines
• Extensive working knowledge of billing and collections for Medicare, Medicaid and commercial payers
• Skill in time management
• Basic Accounting Skills
• Basic knowledge in Microsoft Word and Excel
• Strong attention to detail
• Knowledge and understanding of policies and procedures governing credit balance analysis and resolution of provider contracts with insurance companies

The full job description is available upon request.