HMO / Billing Supervisor at South Shore Women's Clinic

Job Description

• Ensure all bills are captured and ready for review weekly.
• Verify and assess bills before processing.
• Posting of all bills into the hospital software system and HMO portals daily:
  • Organise all HMO bills and record separately.
  • Reconcile all HMO records accurately.
  • Supervise billing and receivables staff.
  • Manage debts efficiently and effectively in order to maintain a strong and healthy cash flow.
  • Ensure treatment approval is gotten and follow up on HMO approval request.
  • Produce daily reports to doctors with regards to HMO Approvals.
  • Verify clinic list daily to ensure eligibility of HMO Enrolees and what they are covered for.
  • Keep up to date with all the HMO processes and procedures.
• Recording of received claims into the claims register.
• Verification / Confirmation of claims
• Preparing of the payment schedule.
• Archiving of paid claims for future reference.
• Maintaining records of P.A codes generated for claims vetting purposes.
• Claim capturing and processing.
• Batching and storage of claims documents.
• Advise account / finance department on captured Claims submitted by providers.
• Ensure all bills are properly dispatched to the respective companies / HMO monthly.
• Implement quality billing practices and procedures.
• Assist and support audit team in verifying bills and billing data.
• Support other departments and personnel in billing process.
• Work with Accounts team to implement in-process data system
• Create and distribute operational and billing reports to management
• Ensure compliance with company policies, and state and federal regulatory bodies
• Other duties assigned by the accountant.