Job Description

MEDICAL BILLING SUPERVISOR

JOB CODE 62020

Effective Date:	07/06N

DISTINGUISHING FEATURES OF THE CLASS:

The fundamental reason this classification exists is to manage and supervise ambulance transport billing and collection activities to include AHCCCS, Medicare, Commercial Insurance (i.e.: Blue Cross-Blue Shield, CIGNA, Humana, United Health Care, Pacificare, HealthNet, AETNA, etc.) and Private-Pay accounts. The incumbent participates in billing systems design to insure maximum collection of revenue; establishes policies and procedures required for effective billing and collection processes; and responds to issues and concerns of City officials. Supervision is exercised over a team of accounting, administrative, and clerical staff. Work is performed under the general supervision of the Fire Financial Services Manager and is reviewed primarily in terms of results obtained.

ESSENTIAL FUNCTIONS:

• Coordinates and manages the work of the ambulance billing and collection staff;
• Performs technical analysis of ambulance payor activity;
• Advises the department regarding ambulance billing and collection issues;
• Evaluates and resolves ambulance billing system problems;
• Reviews, coordinates, and updates all compliance issues regarding Federal, State, and City rules and regulations;
• Reviews, coordinates, and updates all payment options and methodologies to insure accurate and timely collection of revenue;
• Reviews, coordinates, and implements all changes to payor claim submission processes;
• Prepares and presents formal and informal instruction to personnel;
• Conducts program presentations before senior staff members, City Council, and/or other officials;
• Prepares and administers the annual ETS budget;
• Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and work cooperatively and jointly to provide quality seamless customer service.

Required Knowledge, Skills and Abilities:

Knowledge of:

• Arizona Health Care Cost Containment System (AHCCCS) plan rules, regulations, and detailed provisions of claim submission requirements;
• Medicare rules and regulations;
• Health Insurance Claim Form (HCFA-1500) requirements for medical billing purposes;
• Accounting principles and practices;
• Arizona Department of Health Services (AZDHS) Ambulance rules and regulations;
• Commercial insurance claim requirements;
• Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance;
• Electronic claim submissions and remittance procedures;
• Principles and practices of supervision and personnel management.

Ability to:

• Perform a broad range of supervisory responsibilities over others;
• Develop and implement plans, policies and procedures for ambulance billing and collection operations;
• Read and interpret financial statements;
• Communicate orally with customers, co-workers, and vendors in face-to-face, one-on-one settings, in group settings, or using a telephone;
• Comprehend and make inferences from written material in the English language;
• Enter data or information into a terminal, PC, or other keyboard device;
• Work safely without presenting a direct threat to self or others;
• Produce written documents with clearly organized thought, using proper English sentence construction, punctuation, and grammar;
• Work cooperatively with other City employees;
• Monitor or observe data to determine program problems;
• Remain sitting for long periods of time while working at a computer.

ACCEPTABLE EXPERIENCE AND TRAINING:
Five years of experience developing, evaluating, using, and maintaining ambulance billing and collections systems, including two years of experience supervising staff performing billing and collections activities, and a bachelor’s degree in business, public administration, management, or other related field. Other combinations of experience and education that meet the minimum requirements may be substituted.