Medical Bill Review Supervisor

Location: Lakeland, FL between Orlando and Tampa
Job ID: 26192BR
Department: Risk Management
Date Posted: Sep 28, 2023

$65 - 99k

Onsite

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Description

Publix Super Markets tops the list of privately-owned supermarkets in the US. We hold no long-term debt and continue to grow year after year. Publix and our associates excel in community involvement, volunteerism, and environmental sustainability. Our collective commitment to diversity has contributed to our success in being a great place to work and shop. It’s satisfying to work for – and be an owner in – a Fortune 100 company that is widely recognized as a leader in the supermarket industry.

The Medical Bill Review Supervisor oversees the multi-state workers compensation clinical billing process, ensures payment of bills are in compliance with with the respective state department of financial services, and monitors the relationship between Publix and its clinical care and bill review vendors.

In Publix’s corporate offices, we value in-person interactions, similar to those our store associates have with customers. Many of Publix’s corporate offices offer work from home up to two days a week. Each business area implements their policy differently and should be discussed during interviews.

What you’ll do

• Supervise clinical services utilization and bill payment functions, and monitor and direct associates
• Collaborate with IT services to create and manage data tracking reports to measure medical spend, timely billing and staff productivity
• Coordinate with software vendors to resolve technical issues which may impact the billing process
• Supervise the utilization of clinical services by clinical providers and ensure that provider billing is in accordance to contractual agreements with Publix and our Preferred Provider Organization (PPO)
• Oversee the bill reconsideration process with respect to denied or contested medical billings and ensure the process is administered in compliance
• Supervise the electronic data exchange of medical billing information with the Department of Financial Services in the respective states that require it

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Required Qualifications

• Bachelors degree in any discipline or equivalent applicable experience
• At least three years in hospital, medical provider billing, insurance bill review operation, or workers compensation billing
• Experience supervising or leading others
• Medical terminology certification
• Driver’s license
• Knowledge of medical CPT and ICD-9/10 coding
• Intermediate skills with Microsoft Word, Excel
• Basic skills with Microsoft Powerpoint
• Ability to communicate effectively in written and verbal format
• Ability to work with little supervision
• Interpersonal and customer service skills
• Willingness to work nights and weekends when necessary
• Willingness to travel with some overnight stays as needed

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Preferred Qualifications

• Bachelors degree in business administration or computer billing/accounting
• Five or more years of multi-state billing for hospital, insurance or workers compensation in a supervisory role
• Certified coder
• Knowledge of multi-state Workers Comp fee schedules and billing requirements
• Advanced skills with Microsoft Word and Excel
• Familiar with billng claims systems/software

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Benefits

• Employee stock ownership plan that contributes Publix stock to associates each year at no cost
• An opportunity to purchase additional shares of our privately-held stock
• 401(k) retirement savings plan
• Group health plan (with prescription benefits)
• Group dental plan
• Group vision plan
• Sick pay
• Paid Parental Leave
• Long-term disability insurance
• Company-paid life insurance (with accidental death & dismemberment benefits)
• Tuition reimbursement
• Vacation pay
• Free hot lunches (buffet-style) at facilities with a cafeteria
• Paycheck direct deposit
• Credit union
• Access to over 50 discount offers including discounts on computer, vehicle and wireless purchases
• 6 paid holidays (associates can exchange the following holidays with their manager’s approval: New Year’s Day, Memorial Day, Fourth of July, and Labor Day).

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Additional Information

Your application may have additional steps that you will need to complete in order to remain eligible for consideration. Please be sure to monitor your email, including your spam folder, on a daily basis for critical, time-sensitive emails that could require action within 24-48 hours.

Please do not use your Publix email address when applying. Once your application has been successfully submitted you will receive a confirmation email.

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