Supervisor-Insurance Billing

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

As a Supervisor of Insurance Billing, you will be responsible for ensuring the timely, accurate, and compliant submission of all medical claims, including secondary billing and rebilling. You will supervise daily electronic billing processes, including prebill edits and claim rejections.

You will also direct billing activities in alignment with Presbyterian PFS policies, CMS rules and regulations, and all applicable thirdparty payer requirements. In partnership with the manager, you will assist in monitoring unbilled accounts and support the development of strategies to improve clean claim rates and reduce gross days outstanding.

Key core duties:

• Supervise daily billing operations - Oversee the daytoday work of the Insurance Billing team to ensure accurate, timely, and compliant billing in alignment with CMS guidelines.

• Monitor quality and performance standards - Review billing reports, develop improved methods and processes, and coordinate resources to enhance billing and collection efficiency.

• Identify claim trends - Analyze patterns in resubmitted or adjusted claims and address inconsistencies requiring updates to billing guidelines or system modifications.

• Evaluate billing processes - Regularly assess the effectiveness of billing policies, workflows, and automation, recommending changes to improve costbenefit outcomes and maximize collections.

• Ensure account processing accuracy - Monitor systemgenerated reports and quality audits to ensure all accounts meet established performance standards.

• Review problem accounts - Assist the manager with random audits of problematic accounts and ensure timely acknowledgment and resolution of issues.

• Lead staffing and performance management - Oversee hiring, coaching, counseling, and disciplinary actions; maintain schedules to ensure adequate staffing for daily goals.

• Promote highquality customer care - Lead the team in delivering exceptional service that strengthens patient and payer relationships.

• Oher duties as assigned.

Qualifications:

• One to two years of college or three years of healthcare business office experience.
• Billing background - Two years of healthcare billing and/or collections experience.
• Insurance knowledge - Strong understanding of billing and reimbursement processes.
• Coding proficiency - Familiar with medical terminology, ICD10, CPT, and HCPCS.
• Claims expertise - Knowledge of CMS1500, UB04, 837 claims, and 835 remittances.
• Communication skills - Able to communicate clearly with customers, providers, and peers.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.