The Supervisor is responsible for the management of insurance appeals accounts receivable, contract variance analysis and appeals, and coding/medical necessity denials. Supervises patient account representatives; monitors work production; identifies problems and implements resolutions; coordinates staff schedules. The Supervisor participates in program development and department performance improvement, writes employees' performance evaluations and makes recommendations for disciplinary action. Assures performance standards are met for quality, productivity and timeliness.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Monitor work production of Patient Account Representatives in Insurance Appeals Follow Up and Analysis.
Assures staff provides accurate, sensitive, timely responses to patient questions and concerns.
Acts as second level of escalation for customer complaints
Monitors Insurance Accounts Receivable (AR) levels, identifying problems and recommending changes to effectively reduce Days in AR
Ensures the Clinic collects reimbursement in accordance with payor contracts
Perform trend analysis of coding and medical necessity denials to conduct process improvements to eliminate/reduce denials
Collaboratively with IT and Training, monitors workflows and system-enhancement opportunities to optimize efficiency and effectiveness.
Coordinate schedules of staff to ensure adequate coverage.
Calculates and reports productivity measurements to Manager, Insurance AR Management.
Recommends, monitors and reports individual and team goals.
Write and perform employees' performance evaluations and makes recommendations for disciplinary actions.
Interviews and selects new staff.
Develops, maintains and assures compliance with Policies and Procedures for the team.
Assure staff are trained, meet competency standards and follow existing policies.
Assures staff are trained in insurance regulations, compliance, CPT and ICD-10 coding.
Maintain knowledge of the Correct Coding Initiative guidelines.
Meets weekly with the Manager, Insurance AR Management to review the status of KPIs, departmental goals and projects.
Trains staff on Epic system upgrades.
Participates in Epic system testing.
Leads and participates in ad hoc teams to improve clinic-wide and business services processes.
Other related duties as requested.
EDUCATION AND SKILLS
Minimum of an Associate's Degree or equivalent experience in healthcare billing and collections required.
Previous supervisory experience preferred.
Experience in insurance billing regulations and requirements required.
Experience in a medical business environment strongly preferred.
Proficient in Microsoft Word and Excel software required.
Experience with reimbursement payment methods required.
Experience with patient collections and customer service preferred.
Experience with effective cash handling procedures required.
The above information is intended to indicate the general nature and level of work required in this position. It is not designed to contain or be interpreted as a comprehensive description of all duties, responsibilities, and qualifications required of those assigned to this job.
We offer a competitive Total Rewards Program which includes insurance programs covering medical, dental, vision, life, long-term disability, generous time off, holidays, education reimbursement, and a 401(k) plan. Eligibility for benefits is dependent on factors such as position type and FTE. Contact your recruiter for more information.
Vancouver Clinic is proud to be an Equal Opportunity Employer. Vancouver Clinic does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, gender identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
