Billing Supervisor-Ancillary Services - The Primary Health Network

Position Overview:

This position will be a resource for the Director of Billing and Utilization Review for day-to-day oversight of the ancillary services of the billing department and contribute to the fulfillment of the Networks mission by serving as a role model.  Ancillary services include payment posting, the sliding fee discount program, collections, interns/seasonal employees, and special projects.  Additionally, this position is responsible for negotiating and interpreting insurance contacts as well as reviewing fee schedules.

Essential Function:

• Reviews all insurance contracts and requests necessary changes
•            Reviews remittance advice for payment accuracy and or contractual adjustments to ensure reimbursement is paid based on contract rates
•             Research reimbursement patterns for areas/locations of our sites compared to our rates
•             Performs annual impact analysis of Medicare and Medicaid annual rate changes
•             Performs annual impact analysis of fee schedule changes
•             Researches new procedure codes and reviews reimbursement rates with insurance companies
•             Reviews insurance updates, stays apprised of changes, and attends meetings with insurance carriers and representatives
•             Works with other departments and/or contractors as needed to optimize reimbursement i.e.: CHIP and WRAP
•             Builds strong working relationships with provider relations representatives at the insurance companies
•             Maintains confidentiality and integrity of data contained in provider contract and credentialing files as well as patient, employee, and organizational information.
•             Ensures the activities of the ancillary billing operations within the Network are conducted in a manner that is consistent with overall department protocol, and are following federal, state, and payer regulations, guidelines and requirements.
•              Assists in the development and implementation of policies and procedures, in accordance with federal and state regulations and company mission.
•             Oversees the supervision of ancillary personnel, which includes time card approval and changes, work allocation and production, training and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peek productivity and performance.
•             Assist with month-end close duties of billing system. 
•             Assist Finance Department with duties as assigned. 
•             Performs other department related duties as assigned.

Location and Hours of Position

PHN Billing Department: 118 Vine Avenue, Sharon, PA 16146.

The general office hours for this position are Monday - Friday 8:30am - 5:00pm.

PHN does recognize education, experience and location when determining wage

Qualifications:

 Bachelor’s degree, preferably in a business administration or related field. 

• Five years medical office experience in Contracting, Billing, A/R, Credentialing, or Collections.
• Knowledge and understanding of the insurance industry’s trends, directions, issues, and regulatory considerations
• Knowledge and understanding of state laws and regulations affecting insurance practices and FQHCs
• Knowledge of third party and insurance procedures, regulations, billing requirements, and government reimbursement programs
• Strong attention to detail, ability to problem solve and prioritize
• Must possess excellent computer skills, including proficiency in Microsoft Word, Excel, and Outlook.
• Skilled in establishing and maintaining effective working relationships with others

Benefits

Choosing PHN means more than a job title; it's a holistic experience that nurtures every facet of your well-being and aspirations.

• Medical/Dental/Vision (Employee and Family plans available immediately upon start date!)
• Employer Paid Short Term disability
• Employer Paid Life Insurance
• Retirement Plan
• Paid Time Off
• 8 Paid Holidays
• College Savings Plan
• Fitness Center Membership Reimbursement
• ID Shield & Legal Shield
• Volunteer Time Off Program

The Network

The Primary Health Network is the largest Federally Qualified Healthcare Center (FQHC) in the state of Pennsylvania. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring inclusive and equitable access to healthcare that is both compassionate and exceptional. 

With the Joint Commission Accreditation, we adhere to the highest standards of safety and quality in healthcare, ensuring top-notch services that surpass industry benchmarks. Some additional achievements that exemplify our commitment to optimal health and wellness include: 

     • Patient Centered Medical Home Accreditation

     • Age Friendly Care Health System Participant 

     • HRSA Community Health Quality Recognitions in COVID-19 data reporting, advancing health   information technology for quality, and continued implementation of the Primary Care Medical Home care model.

     • Ranked an impressive #5 in the Government & Non-Profit sector by Inspiring Workplaces of       North America for 2023

Innovation Through Diversity 

Our path to DEI&B excellence is paved by the remarkable individuals at Primary Health Network. We celebrate the unique backgrounds, insights, and stories they bring. By attracting, nurturing, and retaining talent from all horizons, we're building a space where fresh ideas flourish, ensuring our patients always receive top-tier care.

Primary Health Network is an Equal Opportunity Employer (EOE)