Level of educational degree and years of experience in hospital administration and/or multi-specialty physician practice, with full exposure to managing the accounts receivables, physician billing, and CPT-4/ICD-10 coding with medical terminology will identify the appropriate candidate
Ability to read, analyzes, and interprets common and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conforms to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.
Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to define problems collects data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Understanding of medical terminology and protocols
Collectively knows how to effectively collect on pass due accounts.
Coaches and assists assigned personnel to maximize productivity and teamwork which includes providing work direction, managing performance, supporting training and development, administering company policies and fostering positive employee relations;
Coordinates activities related to insurance claim processing with other departments to ensure activities are efficient and consistent with the rest of the organization;
Communicates insurance claim filing and collection problems and issues to supervisor and makes recommendations regarding changes to insurance claim filing approaches, policies and procedures. Advises staff within and outside the department of changes;
Audits accounts processed by Claims Analysts to ensure that accounts are addressed and processed in a timely and correct manner. Provides back-up support as needed;