Health Insurance Operations Director directs and oversees health insurance operations programs in multiple service areas, including account installation, implementation, client support, contract administration, claim processing, and enrollment and eligibility. Manages vendors assigned to each operation. Being a Health Insurance Operations Director resolves issues within each service area. Has deep knowledge of health insurance operations. Additionally, Health Insurance Operations Director typically requires a bachelor's degree of business administration or its equivalent. Typically reports to top management. The Health Insurance Operations Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Health Insurance Operations Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Lead Insurance Billing Specialist
Singing River Health System Administrative Building - Gautier | Full-Time | Days |
United States
Position
Overview:
The Lead Insurance Billing Specialist
is responsible for assisting the Billing Manager and fellow staff in billing
activities for Medicare, Medicare Advantage, Medicaid, and Third party claims.
This position ensures timely and accurate billing and collection of hospital
accounts, including acute care, hospice, and skilled nursing services. The Lead
Hospital Billing Specialist is responsible for training of new billing staff
and communicating process issues and improvements to the Billing Manager and
Lead Billing Coordinator. They oversee the billing of complex hospital
accounts, monitors appeals, audits, and assist whenever a higher level of billing
expertise is required.
The Lead
Insurance Billing Specialist keeps abreast of all billing compliance,
including insurance laws and
Government
regulations; patient rights, signature requirements, payment policies and
other related policies; monitors, updates and applies billing compliance
regulations at all times; and assures that employees receive adequate guidance
and instruction concerning duties and billing guidelines. They work with the
Revenue Cycle and other Health System departments in problem solving and recommend long-term solutions. Expectation
is for all performed duties to be in accordance with Singing River Health
System procedures and policies, accreditation organization, and governing
guidance and publications for health care employees.
DISCLAIMER: This is not necessarily an exhaustive list of
all responsibilities, duties, skills, efforts, requirements or working
conditions associated with the job. While this intends to be an accurate
reflection of the current job, management reserves the right to revise the job
or to require that other or different tasks performed as assigned.
Education:
High School diploma or equivalent
required. Associates or bachelor’s degree in business finance, healthcare
administration, or related field preferred.
License:
N/A
Certification:
N/A
Experience:
Minimum three (3) years of Hospital
patient accounting and/or insurance experience in medical field required.
Must have strong Medicare and Managed Medicare insurance knowledge. Must have
strong knowledge of medical terminology, CPT, NCCI edits, and standard payer
code sets. Epic experience preferred.
Reports
to:
Billing Manager
Supervises:
None
Physical
Demands:
Work involves moderate physical activity: frequently moving about
the office, building, or other facilities within the SRHS service area;
frequently positioning self to access files, computers, equipment, and other
objects; performing repetitive motions with wrists, hands and fingers in using
the keyboard and other office equipment; and regularly exerting up to 30 pounds
of force to move objects.
Work involves being able to perceive the nature of sounds at
normal speaking levels, with or without correction. Must demonstrate the
ability to communicate, speak, and enunciate to express / exchange ideas and
detailed information in person and on the telephone. Work requires a minimum
standard of visual acuity, with or without correction, with the ability to adjust
the eye to bring an object into sharp focus, i.e. shift gaze from viewing a
computer monitor to forms that are closer to compare data at close vision.
Mental Demands:
Must be with sound technical skills, analytical ability, good
judgment and strong operational focus; must be well-organized and
self-directed. Work requires the ability to read, analyze, and interpret the
most complex documents. Must
demonstrate the ability to apply advanced financial and mathematical concepts
and operations.
Must demonstrate keen mental faculties / assessment and decision
making skills in the management of financial responsibilities, staff, and/or
patients. Must possess emotional stability conducive to dealing with high
stress levels associated in dealing with employee issues and demands of
maintaining effective working relationships with peers, staff, managers,
physicians, and other healthcare associates.
Special Demands:
Must possess superior customer
service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must
be keyboard proficient) and other office technology (i.e., telephone, fax,
etc.). Must have working knowledge of
MS Outlook, Word, Excel, and PowerPoint.
Work requires the ability to function independently, adapt to workload
demands, set priorities, and understand and set goals. Must understand the fundamentals of
automated data processing, and quickly gain a detailed understanding of
complex computerized and non-computerized information.
Must possess
knowledge of medical, coding, and billing terminology. Must have an
understanding of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply. Must
be able to navigate within an Electronic Medical Record
(EMR).
Clear All
0 Health Insurance Operations Director jobs found in Pascagoula, MS area