Pro Fee Supervisor
Classified Title: Pro Fee Supervisor
Role/Level/Range: ATO 37.5/03/OF
Starting Salary Range: $40,019-$55,058
Employee group: Full Time
Schedule: M-F 8:30am-5pm
Exempt Status: Salaried Exmpt
Location: 16-MD:JH at White Marsh
Department name: 10002800-SOM DOM Billing
Personnel area: School of Medicine
This position is responsible for ensuring that all third-party reimbursement is at expected levels and that third-party rejections, which are determined to be inappropriate, are resubmitted for proper adjudication, assisting Medicine staff with all AR-related issues, and monitoring of staff EPIC, Availity data to insure that all areas are being appropriately handled and that all work items are completed correctly and in an efficient manner.
Mentor and assist Medicine staff of 14
- Insurance Follow-Up, Third-Party Correspondence, and Claims and Documentation.
- Schedules and approves electronic E-210 timekeeping for staff.
- Assists in developing billing policies and procedures for the Department’s professional fee billing office consistent and complementary to those already developed by the Physicians Billing Service.
- Keeps abreast of the current changes and requirements of several hundred different payors, coding changes, and ensures that the office procedures meet these requirements as well as compliance billing guidelines.
- Interacts with 14 Division managers and 1200 providers to answer billing related questions and helps them to better understand the various billing related issues.
- Researches and resolves problems as needed.
- Maintain CPA guidelines in Patient Inquiry database.
- Interface with third-party professional relations representatives to include commercial, HMO and state agency representatives. Periodically meet with representatives to discuss reimbursement problems, where applicable.
- Interface with Medical Service Plan personnel assigned to computer system maintenance regarding unprinted claims.
- Report third-party rejections for incorrect registration information back to originating source
- Review on a monthly basis all unapplied/overage accounts and assign on going clean up tasks to staff.
- Report regularly data entry errors found on claims to Supervisor of Data Operations both electronic and tape.
- Report Systems problems related to the printing of claims to the Medical Service Plan both electronic and tape.
- Develop as necessary, all patient statement messages and correspondences generated by billing office.
- Attends and participates in various committees, meetings, and other forums as needed to stay informed of organizational initiatives that impact the billing office and represents the Departments interests as needed.
- Participates in expert capacity in the Individual QA Incentive Program. Reviews and approves Individual QA’s for several Production Units.
- Schedules interviews and recommends employment for potential staff to Human Resources liaisons.
- Participates in professional development activities.
- Maintains strictest confidentiality.
- Performs other duties as assigned.
Requires highs school diploma/GED, and a minimum of 5 years professional fee billing experience and 3 years of insurance follow-up experience. Requires in-depth knowledge of academic Department of Medicine specific billing issues and experience in an academic Department of Medicine professional fee billing office. Requires a minimum of 1 year of lead or supervisor experience.
CPC strongly preferred.
Additional education may substitute for some experience, to the extent permitted by the JHU equivalency formula.
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.
The successful candidate(s) for this position will be subject to a pre-employment background check.
If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office at email@example.com. For TTY users, call via Maryland Relay or dial 711.
The following additional provisions may apply depending on which campus you will work. Your recruiter will advise accordingly.
During the Influenza ("the flu") season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.
The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.
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