Supervisor, Central Scheduling & Insurance Verification

Employment Type:

Full time

Shift:

Shift_8

Description:

Job Summary and Minimum Qualifications

Job Title: Supervisor, Pre-arrival Services Job Code: S4153

FLSA Status: Exempt

General Summary:

Administrative/Supervisory Responsibilities: This position is responsible for supervising the daily operations of central scheduling, pre-registration, and insurance verification.

Provides staff training, coaching and support; issue identification, assessment and resolution; and technical support within the Central Scheduling and Insurance Verification Unit in order to achieve desired outcomes and compliance with Holy Cross Hospital policies/procedures and standards. Provides input to Manager in performance evaluations. Coordinates workflow for Central Scheduling and Insurance Verification Unit to ensure that operational and customer service standards are maintained.

Works with patients, physicians, physician office staff, third party payers, and case management departments to secure hospital reimbursement and avoid authorization denials. May perform quality assurance reviews and analysis to support internal controls, monitor employee and departmental performance daily, and assist in staff development and retention. Maintains and keeps abreast of insurance requirement changes and shares knowledge with hospital staff as needed.

Pre-Service / Scheduling Responsibilities: The Supervisor also serves as a scheduling and pre-service representative.

In this capacity, the representative obtains demographic, clinical, financial and insurance information during the process of making appointments for patient tests and procedures. Provides instructions to the patient on test preparation; prints and mails patient itineraries if lead time is sufficient. Validates medical necessity / Local/National Coverage Determinations (LCD/NCD) of requested cases to support clinical and financial clearance functions.

Obtains and processes signed physician orders to ensure clinical documentation for care delivery as appropriate. Performs pre-registration activities and initiates, evaluates and responds to results of real-time eligibility verification. Completes benefit analysis, collects patient financial obligations and ensures that notification/certification are established for all payers.

Supports the Mission of Trinity Health and Holy Cross Hospital.

Minimum Licensure/Certification Required (if applicable):

• Certified Healthcare Access Associate (CHAA) credentials by the National Association of Healthcare Access Management (NAHAM) and/or Certified Patient Account Technician (CPAT) credentials by the American Association of Healthcare Administrative Management (AAHAM) are preferred.

• At least one-year supervisory experience in a healthcare provider and/or payer environment, with 3-5 years hospital scheduling, pre-registration, and/or insurance verification experience.

Minimum Knowledge, Skills, and Abilities Required:

• High school diploma required. Associate's Degree preferred.

• Proficient computer and data entry skills (35 minimum keystrokes per minute with high degree of accuracy) required. Microsoft Office (Power Point, Excel, Word) proficiency required. Must be able to navigate between multiple information systems as quickly and efficiently as possible.

• Working knowledge of medical terminology preferred.

• Excellent communication (verbal and written) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers, including the ability to interpret customer requirements, recommend and take action to satisfy the customer's needs.

• Accuracy, attention to detail and time management skills are required.

• Must be comfortable operating in a collaborative, shared leadership environment.

• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Holy Cross Hospital.

• Fluency in multiple languages is preferred. Fluency in English and at least one other language that meets the department requirements is preferred for this role, and allows Holy Cross Hospital to better serve their community and patient population.

Supervisor Statement:

Supervisor:

Management at Holy Cross Hospital involves understanding that we operate within a fiduciary relationship in which we are expected to steward our communities resources in such a way that we produce high quality, safe, efficient, and effective care for both today's patients and tomorrow's patients. This enables us to become the most trusted provider of health services within our community.

A Supervisor at Holy Cross has resource monitoring and staffing responsibility for either a specific department function or for a certain shift and number of employees. Supervisors must have the ability to organize day-to-day workflow and prioritize, adjust, and redistribute workload as necessary to assure that optimal service and resource use is achieved within the unit being supervised.

The supervisor has primary responsibility to ensure that departmental and organizational policies are consistently communicated and that practice within their area of responsibility is aligned with these expectations. The supervisor is also the primary management contact for staff concerns, and directly oversees the communication of organizational objectives to the staff. Communication skills and the ability to educate staff are important elements of this job.

Working Conditions:

Physical Requirements:

Exerting greater than 25 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and up to 10 pounds of force constantly to move objects. Physical demand requirements are in excess of those of light work.

Visual Acuity:

The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices; and/or assembly or fabrication parts at distances close to the eyes.

Environmental conditions:

Physical demand requirements are in excess of those of light work; typically office or administrative work.

Reporting Relationship:

Reports to the Manager, Pre-arrival Services/Director, Patient Access

Revision Date:

March 1, 2018

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do.

Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve.

Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.