The mission of The University of Texas MD Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.
The Patient Financial Services - Eligibility Supervisor of the Financial Clearance Center is responsible for creating a positive patient experience by providing direct supervisory oversight of the Financial Clearance Associates and the day to day operations relating to financial clearance activities. This includes proper management and adherence to department policies and procedures related to the verification of eligibility/benefits. The Eligibility Supervisor will serve as a resource for the FCC using such knowledge to assist with facilitating insurance verifications and driving meaningful discussions with the insurance payors and patients to include technical competence and demonstrated proficiency with medical insurance plans, regulations and managed care plans. Familiar with multiple payers' insurance verification guidelines and processes and the ability to obtain payer-specific details, as necessary to ensure accurate coordination of benefits with demonstrated knowledge of effective management techniques. The Eligibility Supervisor will assist the Manager with establishing and delivering ongoing education and training to new and/or existing staff. The Eligibility Supervisor is also responsible for the hiring, evaluating and providing ongoing mentoring and feedback to designated staff.
Supervises and coordinates operational activities related to the timely and complete verification of eligibility and benefits verification processes, understanding the revenue cycle and supervising and motivating
Experience in using team building and quality management concepts to positively influence the work environment
Demonstrates understanding of payor groups, and individual health plans (payor plan codes) and knowledge of payors contracted with MD Anderson and process for completing spot agreement when necessary
Performs quality and assurance checks; reviews case documentation for completeness and accuracy, and ensures compliance with MD Anderson policies
Responsible for ensuring the verification of insurance is complete for each MD Anderson patient
Reviews, tracks and manages activities related to designated departmental work queues to ensure timely resolution of patient accounts
Provides direction and support to FCC staff with interpreting and understanding payor medical coverage policies to drive meaningful discussions with payors regarding insurance verification request and/or continuity of care needs
Acts as a liaison to assist with maintaining effective relationships and resolving matters, including escalated FCC issues that require interactions directly with Patient Access, Clinical Operations, a health plan, third party vendor, and/or new/existing patient
Provides ongoing updates and education to staff regarding payor related requirements
Maintains knowledge of systems and processes that impact admissions, verification and other patient access related functions
Assist Manager with developing and revising plans for continuous improvement to ensure the department maintains compliance with established FCC, institutional and required regulatory policies and procedures
Responsible for monitoring daily activity and performance metrics reports to assist with improving process flows and procedures
Reviews and understands the denials process and patient bad-debt that resides under the eligibility function
Responsible for maintaining Eligibility and Benefits for each MD Anderson patient
Ensures insurance coverage is obtained and resolves any issues with coverage and escalates complicated issues to a manager
Required: Bachelor's degree in Business or Healthcare Administration.
Required: Six years of experience in patient registration, medical financial counseling, and/or insurance verification in a healthcare setting to include two years of lead/supervisory experience.
May substitute required education degree with additional years of equivalent experience on a one to one basis.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Employee Status: Regular
Minimum Salary: US Dollar (USD) 52,000
Midpoint Salary: US Dollar (USD) 65,000
Maximum Salary : US Dollar (USD) 78,000
University Of Texas M.D. Anderson