Supervisor, Accounts Receivable
Summit Health Inc - rocky hill, CT
Apply NowJob Description
About Our Company We're a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians. When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care. Job Description The Supervisor assists the Patient Accounts Manager to ensure that timely response to all incoming communications related to patient billing activities is achieved. The supervisor demonstrates understanding of billing and collection policies, regulations, and other protocols. The Patient Accounts Supervisor is responsible to direct the tasks for a team of five to ten Patient Accounts Specialists. The Supervisor ensures that the Athena workflow in patient billing is developed and maximized within the team to ensure optimal customer service. Teams are developed to provide exceptional customer service, problems solve their issues as they develop, and set priorities in claim review. Training will be an important function of the Patient Accounts Supervisor within their teams. Essential Job functions: • Provides leadership and support in problem solving within the Patient Accounts Department serving as a role model & consultant for staff. Assists in interpreting policies & procedures. • Demonstrates the ability to make decisions & delegates responsibility to ensure high quality performance & efficiency. • Assists manager with management functions such as providing feedback on performance reviews, assistance with payroll & variance reports and other daily operational functions. • Supervises the monitoring and completion of the patient account call workflow for their Team, seeking the goal of "One Call Resolution". Researching and correcting claims Writing appeals and facilitating their submission by Athena for appealing adverse decisions Contacting payers & medical directors as needed All other activities that lead to the successful adjudication of eligible claims • Supports the training of the Patient Accounts Specialists to ensure complete system knowledge, ability to analyze accounts, work correspondence, research & resolve assigned unpostable payment batches; reporting staff deficiencies to the Manager • Proficient in coding & billing guidelines to ensure maximized reimbursement of claims Reviews medical record for proper assignment of diagnoses & procedure codes according to AMA, ICD-9-CM, CPT & CMS Guidelines Utilizes Athena Code Check and other resources (CCI, CPT, ICD-9, HCPCS, coding manuals, Payer policies) to ensure correct coding and efficient claim processing nsures compliance related issues are identified and reported to Compliance Department • Illustrates excellent knowledge of healthcare industry in regard to the revenue cycle, coding, claims and state insurance laws. • Illustrates excellent knowledge of healthcare industry in regard to the revenue cycle, coding, claims and state insurance laws. • Runs regular meetings with their Team and reports to Manager. • Manages the coordination, creation and implementation of patient account related processes that may affect the department as well as various disciplines of the organization to ensure accurate reimbursement. • Completes draft of yearly staff evaluations for manager approval and assists manager in the staff presentation of evaluations. • Works with insurance provider representatives to resolve outstanding claims/issues. • Ensures appropriate procedures are followed for write-offs. • Ensures acceptable A/R standards per SMG policy and business office budget goals. General Job functions: • Expert in Athena Collector co-sourcing model. • Expert in research, oversight and management of outstanding AR under the Athena category "Self Pay" in athenaNet: • Self Pay Account Worklists and Self Pay alarms Collection Worklists Kickcodes - what they are and what they do Claim note history including actions and claim statuses • Expert in Unapplied Worklist process and management Investigation and Denial / Appeal / Preparation of patient refunds • Expert in EOBs and ERA and what they mean in athenaNet • Expert in Communication: Claim notation Physician and Practice location staff Patient Notes / Appt. Notes / Claim Edit Note Peers Manager/Director Appeals and Payers Athena CSC and athenaNet • Expert in Quickview, Registration, and Claim Edit screens, Patient Account View, Billing Summary, and all screens, tools, and data locations available under the user's security access. • Expert in generally accepted insurance benefit terms and processes • Expert in determining and influencing appropriate payment plans for patients and setting them up in athenaNet. • Expert in Unpostable Research. • Expert in request/preparation of supporting documentation such as medical records, dictation, appeal letters, contract pages. • Expert in patient balance policies, workflows, and tools. • Expert in management of TOS payment need(s) • DAILY process of opening, closing and reconciling payment/deposit batches. • Expert in investigation and Denial/Appeal/Preparation of Refunds Patient Insurance • Expert in reporting, Activity Wizard, AR Wizard, Report Builder and any available reports in Library or through other means in Athena. • Expert in customer service to patients and Physicians/Staff. • Expert in Family Billing setup. • Familiar with Patient 5 Stage Workflow Concept. • Familiar with Registration, Scheduling, Check In and Check Out, pre-view and Day End Review, and other procedures, processes, and tools both in SMG policy and athenaCollector. • Familiar with the process of credentialing. • Familiar with Physician staff, practice habits, preferences of communication. • Familiar with excel spreadsheets, Microsoft Word, and other general office processes and tools such as scanning, faxing, email, browsing to SMG servers. • Other duties as required. Physical Job Requirements: • Physical mobility, which includes movement from place to place on the job, taking distance and speed into account • Endurance (e.g. continuous typing, prolonged standing/bending, walking) Education, Certification, Computer and Training Requirements: • High School Graduate/GED required. • 5+ years experience required. • Strong multi - tasking, organizing & priority setting skills • Strong problem solving and critical thinking skills required. • Certified Professional Coder (CPC) preferred. • Ability to communicate in English, both orally and in writing required. • Strong interpersonal and communication skills. • Ability to lead and manage a department (team). • Ability to perform diversified duties with time limitations with a high degree of accuracy. • Demonstrated knowledge of registration operations and third party payer requirements. • Strong skills in cash management. • Experience with Standard Office Equipment (Phone, Fax, Copy Machine, Scanner, Email/Voice Mail). • Experience with Standard Office Technology in a Window based environment. • Experience with AthenaCollector. Anodyne, Microsoft Word & Excel. About Our Commitment Total Rewards at VillageMD Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan. Equal Opportunity Employer Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws. Safety Disclaimer Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, or file a complaint at
Created: 2024-09-23