PFS Supervisor

May 16, 2024 |

Department: Business Office

Status/Schedule: Full Time

Shift: Days

Location: Hartford, KY

For more information contact: Bethany Todd, btodd@ochcares.com

Qualifications:

  • Education: High School Diploma or GED
  • Experience: Preferred 1 year
  • Additional Requirements: CPC preferred. Preferred experience in insurance billing and follow-up. Must be organized. Have good attendance.

Job Description:

  • Responsible for the supervision of Physician and Hospital business office staff.
  • Responsible for the physician and hospital AR performance and AR days reported.
  • Monitoring AR follow-up staff performance and adjusting methods accordingly to increase collections.
  • Reviewing aged AR for each employee and addressing any issues there may be.
  • Signing off on account adjustment requests and refund requests
  • Communicating with insurance payer representatives via meetings or emails when needed about recurring problems in billing or claims processing to resolve ongoing claim/billing issues to maximize collections.
  • Ensuring payers are adhering to contract terms for reimbursement.
  • Researching and staying up to date on insurance payer medical policies and reimbursement policies, sharing them with business office follow-up staff
  • Updating insurance tables in ECW and CPSI, including adding new insurances, or updating information for existing insurances
  • Submitting tickets to ERO, ECW support company, and CPSI to correct errors and resolve various patient accounting issues
  • Creating edits in the ECW software to increase efficiently in billing.
  • Assisting other staff with billing and submitting claims and with correcting errors in their AR report
  • Assisting with appealing denials on claims on which staff is having trouble collecting.
  • Submitting complaints to the KY Department of Insurance when payers are not abiding by reimbursement regulations and contracted processes.
  • Helping with follow-up duties as needed
  • Work high dollar accounts regularly to ensure payments, pull reports monthly to monitor high dollar services.
  • Follows up on older provider base claims to ensure payments get transferred.
  • Responsible for hard closing ECW at the beginning of every month and sending the reports to Accounting for tracking our AR.
  • Sort AR report to distribute to appropriate follow-up staff to work through.
  • Creates/documents claims for patient payments made for filling out of forms like FMLA
  • Responsible for NSF fee for returned checks on ECW billing.
  • Responsible for refund requests in ECW: approving them, receiving check, posting check, mailing check to insurance/patient.
  • Communicates with coding staff to resolve issues.
  • Responsible for every billing aspect of behavioral health: submitting claims, posting insurance/patient payments, following-up on denials, etc.
  • Participating in interviews of new employees in the Business Office
  • Training or assisting in the training of new employees
  • Reviewing/authorizing employee time corrections and errors and benefit time requests while monitoring attendance of physician and hospital business office staff
  • Administering disciplinary action when necessary, according to hospital policies
  • Finding coverage for positions in the business office when staff is out.
  • Completing employee annual evaluations, job descriptions and competency checklists
  • Answering questions from all business office staff regarding various tasks and processes, claims denials, job functions, etc.
  • Attending training webinars from QHR and other learning sites
  • Attending hospital revenue cycle meetings and other leadership meetings
  • Other duties as needed.

Ohio County Healthcare

Ohio County Healthcare is a non-profit Joint Commission accredited health system which provides a wide range of hospital, primary care and specialty physician services.

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