Lifeline Connections

• providing exceptional service to patients with commercial insurance coverage and self-pay accounts. • verifying insurance eligibility and benefits, assisting with payment arrangements, resolving account issues. • serving as a primary point of contact for patient billing inquiries. • contacts patients regarding outstanding balances, denied claims, payment requests, and overdue accounts. • establishing and monitoring payment arrangements as appropriate. • processing and submitting patient refund requests in accordance with established policies and procedures. • maintaining daily account follow-up worklists and assigned account inventories while meeting established productivity and quality standards. • auditing patient accounts to ensure accuracy and completeness of billing and payment information. • providing outstanding customer service to patients, staff, providers, and external stakeholders. • ensuring the integrity and completeness of account records and compliance with HIPAA requirements.

• The RCM Medical Billing Operations Supervisor position works under the supervision of the RCM Manager. • Oversees the front end of the medical billing cycle, namely timely and accurate claim submission processes. • Supervises the Coding and Claim Review Specialists and Medical Billing Assistant. • Ensures acceptable resolution of failed claims in the EHR to promote timely submission of claims. • Monitors unbilled claims and upfront rejections. • Responsible for coding and mapping in the EHR, maintaining payer information, billing configurations, fee matrices, and rules for the claim engine. • Performs RCM Billing Audits and may assist in running regular reports to track department goals and progress. • Provides direct supervision to the Coding and Claim Review Specialists and Medical Billing Assistant, meeting regularly to provide guidance, direction, support, and resources necessary for efficient job performance. • Conducts quarterly and annual performance evaluations and assists staff in establishing and achieving individual goals aligned with departmental objectives. • Troubleshoots, investigates, and resolves failed claims within the claim management system daily to ensure timely claim submission and reimbursement. • Configures, maintains, and monitors payer billing settings, procedure code, bill-next, and adjustment reason code mappings within billing systems. • Applies proactive problem-solving, analytical thinking, and attention to detail to identify, research, and resolve billing, coding, and claim processing issues.