Insurance Supervisor

Summary: Supervises reimbursement (billing/collections) operations to ensure maximum reimbursement from insurance companies, third party payors, and patients for services and products provided.

Qualification Requirements

• Minimum of five years of claims/billing experience.



• Supervisory experience is highly preferred.



• Knowledge of medical billing/collection practices. An above average understanding of debits and credits is required.



• Knowledge of basic medical coding and third-party operating procedures and practices.



• Demonstrated human relations and effective communications skills are required.



• Strong analytical skills.



• Understand the ethics of confidentiality and the ability to maintain confidentiality of sensitive information.



• Ability to communicate well with physicians, staff, public and insurance carriers.



• Maintain a positive and professional attitude in all aspects of work and interactions with co-workers, physicians, and insurance companies.



• Proficiency in Microsoft Office (Word, Outlook, Excel). Understanding and proficiency using word processing and spreadsheets.



• Computer skills also include knowledge of applicable EHR, Practice Management, and Document Manager systems.



• Familiarity with CMS 1500 claim form completion.



• Most current CPT and ICD coding is highly preferred.

Knowledge, Skills and Abilities:

• Detailed oriented and excellent records maintenance skills.



• Strong supervision and motivational skills.



• Ability to communicate effectively both orally and written.



• Ability to be a self-starter with strong independent decision-making skills and attention to detail.



• Ability to foster and promote a cooperative work environment. Possess a willingness to accept orders and to perform repetitive tasks.



• Ability to always treat all employees equally and fairly.



• Knowledge of healthcare billing procedures, documentation, and standards.



• Knowledge of cash management principles and procedures to ensure charge entry and receipt entry reports balance to close of the day report.



• Knowledge of appropriate billing and payment cycles for Medicare accounts.



• Ability to make evaluative judgments.



• Ability to meet deadlines.



• Knowledge of operational characteristics and procedural requirements of third-party medical insurance payors.



• Knowledge or procedural requirements and ethical standards for follow-up of overdue accounts.



• Ability to analyze medical records and identify billable services.



• Knowledge of credit and collection principles, process regulations, and standards.

Supervisory Responsibilities: Yes

Essential Functions (%)

• Supervises daily billing and collections activities to ensure maximum efficiency. Provides guidance and direction to staff, covering all aspects of billing and collection standards/procedures, ensures adherence to policies and procedures and initiates correspondence with insurance companies for reconsideration of claims. 25%



• Ensure accounts are billed within established periods and customer service guidelines/guarantees are adhered to. Keeps abreast of billing regulations/requirements and changes to national uniform billing forms and communicates changes to staff. 25%



• Monitors payment/denial activity for correct reimbursement by payor, keeps Practice Administrator informed of potential reimbursement issues as well as all updates/charges of billing regulations/guidelines. 25%



• Ensure that there is a system of checks and balances in place to ensure that all electronic & paper HCFA 1500s are submitted promptly and correctly. 25%

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to stand and talk or hear. Hearing, visual acuity, depth perception, balancing, handling, and talking.



• The employee is occasionally required to sit and stoop, kneel, or crouch and requires full range of body motion, manual and dexterity and eye-hand coordination. Reaching, grabbing, holding – fine motor skills.



• Extended periods in a stationary or standing position.



• Repetitive motion such as entering data into computer-based programs.



• Lift or move up to twenty-five pounds. Employees are expected to use appropriate ergonomics and tools such as hand carts for heavier loads.



• The employee is required to spend a significant amount of time on the phone and therefore are expected to use the hands-free headsets provided to avoid any injuries.

Work Environment:

• Work is performed in a typical interior/office work environment. The noise level is usually moderate.



• Minimal risk of exposure to blood borne pathogens and OPIM



• Overtime is a condition of employment and individuals may be asked to come in early or stay late as needed to accomplish the mission of the organization. Individual work hours will be determined by the supervisor upon hire based on the needs of the department.