Supv Insurance Follow Up

Job Summary:

Under the direction of the Patient Financial Services Manager and Director and according to established organizational and departmental policies and procedures, this individual will ensure efficient and effective daily operations of the Patient Financial Services Department. These efforts will be addressed through the supervision of processes and systems which will optimize reimbursement and cash flow with high sensitivity to our corporate compliance guidelines. These efforts will also be consistent with the mission and vision statements of * & Community Health. Other duties as assigned.

Essential Duties:

• Responsible for supervision and oversight of the daily operations of Patient Financial Services inhouse insurance follow-up functions and related staff.

• Assists staff in determining work priorities and ensures staff is successfully completing job functions.

• Maintains appropriate staffing levels in the department to ensure excellent customer service and meet departments goals.

• Assesses and justifies need for additional or replacement staff.

• Monitors work queues of respective areas and reassigns staff or redistributes workload as needed.

• Monitors quality and productivity metrics and holds staff accountable for stated goal targets.

• Responsible for providing guidance, training, support and solutions to Insurance Follow-Up staff.

• Works closely with management, staff and other areas to continuously provide and improve service.

• Responsible to ensure and maintain effective resource utilization for assigned area.

• Monitors and trends payer performance and presents findings at Provider Representative meetings.

• Implements action plans with staff to reverse negative accounts receivable trending.

• Monitors and understands denial patterns and provides training and feedback on appropriate denial resolution.

• Escalates denial patterns to Provider Representatives of respective payer.

• Monitors interactions with other departments and third party payors to improve productivity and efficiency and provide exceptional customer service.

• Works closely with clinical departments and other revenue cycle departments on cross functional issues affecting billing, coding, registration and reimbursement.

• Develops, reviews, updates, and implements department policies and procedures on a continual basis.

• Prepares and updates payer reference materials.

• Assists with training staff on policies and procedures.

• Researches and maintains knowledge of policy/procedures of all agencies/third party payers.

• Makes changes to established protocol consistent with agency/payer policies/procedures changes in order to maximize revenue.

• Maintains and initiates changes or additions to the department computer systems, including work listing functions.

• Shares in planning for and communicating change involving other departments and troubleshooting to minimize potential conflicts.

• Selects, motivates, directs, and develops staff to cooperatively achieve departmental goals.

• Hires, terminates, counsels staff and takes personnel action, when necessary, per * & Community Health personnel policies.

• Motivates employees to be productive, positive, contributive member of the team and encourages employees to think without limitations when problem solving.

• Prepares and administers objective annual performance evaluations for staff, based on a set of pre-determined measures or standards, monitored by department head review."

Required Skills & Experience:

• Five years' experience in billing, customer service or collections in a healthcare environment is required.

• Three to four years' leadership experience is required.

• Demonstrated skills in planning, directing organizing and implementing projects.

• Recent experience in healthcare reimbursement and knowledge of medical coding and billing.

• Problem solving and well-developed analytical skills required.

• Effective written and verbal communication skills.

• Well-developed personnel management and leadership experience.

• Experienced user in Excel and Word.

Preferred Skills & Experience:

• Previous supervisory experience is preferred."