Supervisor Medicare - Phoenix, AZ

UHG Phoenix, AZ

About the Job

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)
 
The Medicare Supervisor is responsible for the management of the billing and collections, of all Medicare accounts. This role is responsible for facilitating daily operations of all Billing and Collections functions, including coordination with hospital departments affecting Billing and collections processes. The position requires coordinated activity across organizational lines to ensure a unified and proactive billing process within the organizational units that are serviced across several Centers of Excellence (COE). This position is responsible for managing and coordinating team efforts toward a specific service delivery function for the client. The position provides coaching, feedback, and corrective action to service delivery team members where needed.
 
The Medicare Supervisor carries out his / her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of the client.
 
Primary Responsibilities:
  • Manage the work of the Medicare billing and collections team members by empowering, coaching, answering questions, giving guidance, and leading by example
  • Manage COE operations, ensuring timeliness, accuracy, compliance and standards fulfillment as defined in COE Service Level Agreements
  • Ensure that adequate procedures exist for accurate and timely processing of Medicare, billing and collections.
  • Ensure compliance with state and federal laws regulations for Medicaid, Medicare, non - government and other third party billings
  • Maintain ongoing knowledge of UB - 04, HFCA 1500, and other mandatory state billing forms and filing requirements
  • Monitor on - line claim editing, submission and reconciliation procedures; ensure compliance with CPT, HCPCS and ICD - 9 coding regulations and guidelines.
  • Help coordinate follow - up within appropriate regulations of Medicare and Medi - Cal bills
  • Provide relevant guidance for assigned staff to resolve internal and external issues
  • Inform Director and Managers of any significant issues in the Billing and Collections area (e.g., Billing and Collection backlogs, HIM bill drop delays, payer issues, vendor issues, etc.)
  • Stay abreast of regulatory requirements and company compliance policies, ensuring timely staff education
  • Help ensure that appropriate personnel policies are adhered to and any personnel problems are addressed in an appropriate and timely manner
  • Assist in developing department staff to ensure appropriate skills base is present in the staff, as well as to ensure that skills needed for future needs are
  • developed in advance of their need.
  • Assist in establishing and monitoring controls to ensure appropriate submission and acceptance of electronic and manual bills
  • Monitor billed and rebilled summary reports and act on trends and / or root causes
  • Monitor Billing and collection performance according to quality and productivity standards developed internally and documented in SLAs
  • Support completion of monthly trending analysis of COE billing and collection performance
  • Help coordinate and promote implementation and monitoring of standard master files, processes, reporting and education programs
  • Understand and communicate nuances of billing various payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers, etc.
  • Supervise Medicare Billing and Collection personnel, provide recommendations for hiring, promotion, and personnel action where appropriate
  • Develop specific objectives and performance standards for each area of responsibility
  • Identify and implement process improvements to lower costs and improve service to facility customers
  • Identify opportunities for innovation, knowledge sharing and other leading practices within the COEs and among peer group
  • Perform staff reviews and prepare performance documents for direct reports
  • Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
  • Other duties as assigned

Required Qualifications:
  • High School Diploma / GED or higher
  • 2+ years Medicare or Government Billing and Collection experience
  • Microsoft Windows, word, excel and Outlook Word (create, edit, save) Excel (create, edit, save, plug in data) Outlook (send, receive, set appointments)  
Preferred Qualifications:
  • Bachelor's degree or higher
  • Willing to travel up to 5%
  • 3+ years of Billing experience
  • 3+ years of Healthcare, Hospital and / or Revenue Cycle experience
Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM
 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.


Keywords: Medical collections representative, customer service, collections representative, customer service representative, optum360