SUPERVISOR, PFS (13700)

Cullman Regional; Cullman (AL); On-site; USD 38,000 - 64,000; Full time

Job summary

Cullman Regional Medical Center in Cullman, AL is seeking a Full Time Billing Specialist to support accurate posting, coding, and precertification workflows. You will verify orders, ensure required information, and coordinate with physician offices to obtain approvals.

The role focuses on submitting and following up on claims, minimizing denials, resolving billing discrepancies, and educating staff on procedures. Prior medical terminology experience and strong computer skills are essential.

Qualifications

• Two years of medical terminology experience required; supervisory experience preferred.
• Certification or associate's degree in coding is preferred.
• Must have in-depth knowledge of medical terminology.

Responsibilities

• Ensure accurate and complete posting test, entering orders, verifying medical necessity, and confirming precertification.
• Assist with obtaining new orders if medical necessity is not met and/or pre-certifications are not obtained.
• Verify all physician orders have required information and are scanned into hospital system.
• Work with access and/or physician offices to assure late add-ons are managed properly.
• Review next day schedules to confirm all patients are completed and obtain any additional information needed.
• Communicate regularly to update and validate scheduling guidelines from all scheduling centers.
• Monitor daily workflow and staff productivity to meet departmental goals and performance standards.
• Oversee claim submission and follow-up processes to minimize denials and aged accounts receivable.
• Review denied and rejected claims and develop corrective actions to improve reimbursement.
• Ensure timely and accurate resolution of billing discrepancies and payer issues.
• Develop staff education and training related to billing procedures and revenue cycle processes.
• Serve as a resource and escalation point for complex billing and reimbursement issues.
• Assist management with staffing, scheduling, workflow development, and departmental policies.
• Ensure staff is trained on CPT changes, insurance precertification requirements and medical necessity changes.

Skills

Medical billing terminology

Attention to detail

Communication

Supervisory experience

Education

High school diploma or equivalent

Associate's degree in coding (preferred)

Coding certification (preferred)

Tools

Typing 30 WPM

Computer literacy

Job description

Job Details

Job Location: Cullman Regional Medical Center - Cullman, AL 35056

Position Type: Full Time

Job Shift: Day

Job Category: Health Care

Job Summary

• Ensure accurate and complete posting test, entering orders, verifying medical necessity, and confirming precertification.
• Assist with obtaining new orders if medical necessity is not met and/or pre-certifications are not obtained.
• Verify all physician orders have required information (Physician signature, patient's full name, DOB, diagnosis/reason, and date) and are scanned into hospital system.
• Work with access and/or physician offices to assure late add-ons are managed properly.
• Review next day schedules to confirm all patients are completed and obtain any additional information needed.
• Communicate regularly to update and validate comprehension by staff of scheduling guidelines from all scheduling centers and adhere to all procedural protocols.
• Monitor daily workflow and staff productivity to ensure departmental goals and performance standards are met.
• Oversee claim submission and follow-up processes to minimize denials, delays, and outstanding accounts receivable.
• Review denied and rejected claims, working with the team to identify root causes and develop corrective action plans to improve reimbursement.
• Ensure timely and accurate resolution of billing discrepancies, claim edits, payer issues, and patient account concerns.
• Develop staff education and training related to billing procedures, payer requirements, denials, and revenue cycle processes.
• Serve as a resource and escalation point for complex billing and reimbursement issues.
• Assist management with staffing, scheduling, workflow development, and departmental policies.
• Ensure staff is trained/updated on CPT changes, insurance precertification requirements and medical necessity changes.
• Manage to ensure department is adequately staffed and new employees are thoroughly trained.
• Demonstrate and encourage team behavior and exceptional patient/guest experiences.
• Uphold and promote patient safety and quality.

Qualifications

Education

High school diploma or equivalent required. Certification or associate's degree in coding is preferred. Must have in-depth knowledge of medical terminology.

Experience

Two years' medical terminology experience required; supervisory experience preferred. Phone experience and previous medical office experience are preferred.

Additional Skills/Abilities

• Computer experience required.
• Must be able to type 30 WPM.
• Must be able to communicate well with physician office staff and adjoining departments within organization.
• Must be able to develop and implement policy and procedures and training documents as needed by the department.