POSITION SUMMARY: Assisting management in all new or revisions of EPIC implementation projects. This includes participating in all meetings to discuss changes to our billing and EMR system. Includes keeping detailed notes on assignments needed to complete, gathering information, claims testing and informational feedback to assist in discovering any opportunities resulting in workflow disruption or cash flow changes. Responsible for providing coverage and training for Level I, Level II and Level III (A and B) Associates, as needed, in the clinician group business office. Supervisor will assist with all activities and employees related to all revenue cycle services and processing including: Billing, Cash Posting, Denials Management and contract management with payers. Ensure that all administrative and departmental policies and procedures are adhered to by staff. Demonstrates the ability to assertively pursue necessary information and to function independently to secure resolution on staff, patient issues and payer project issues. Projects a mature problem-solving attitude while dealing with interpersonal conflict, dissatisfied patients and time demands. Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations and internal policies. Assist with productivity data and statistics to monitor staff performance in an effort to seek efficiencies and effectiveness. Supervisor will review and respond to revenue cycle emails for assistance and resolution, will have proficient skills as necessary for Level I, II and III (A and B). Assist in reviewing, investigating, adjusting and resolving complex claims, claims appeals, claim projects, functioning as a liaison with the payers to ensure that guidelines are being followed, inquiries and inaccuracies in payment of claims. Oversee claims quality reviews, identifying trends and systemic root cause analysis. Assist in creating workflows for the department and support team members in understanding changes in work processes. Functions as the primary contact for the AR team, for the payer and for other departments in researching, collection of background information and documentation to address various issues. Supervisor will maintain consistent communication with business office management regarding workflows, issues and concerns. Supervisor will be responsible for identifying payer denial trends and prepare all data for payer meetings for resolutions and sharing root cause analytics with payer representatives.
Ensure a positive work environment, acting as a resource, and leading by example. Responsible for displaying behavior that promotes accountability for performance of job tasks which will meet or exceed the Customer's expectations. Encourage cooperative, collaborative relationship between all employees at all levels. Assist in creating a work environment that encourages and empowers staff to make improvements to their work processes. Assists in the development of departmental policies to ensure procedures are in compliance with State and Federal Regulations, while maintaining consistency with Christus St. Vincent Hospital's philosophy, culture, core values and mission statement. Supervisor will be first point of contact for any payer project requests, research information needed by payer to resolve claim project issues and will be responsible to inform Revenue Cycle management of all issues, resolutions and if needed escalated issues to next level with payers.
Duties, responsibilities and activities may change at any time with or without notice. PB Rev Cycle Supervisor will be expected to be flexible with work schedule and duties, as the needs of the department change. The Rev Cycle Supervisor will be expected to temporarily fill the role of any open revenue cycle position as business needs require and assist Rev Cycle Manager with any projects. PB Rev Cycle Supervisor will be expected to complete her current daily assignments of PB workques.
MINIMUM QUALIFICATIONS: Demonstrated proficiency in all Level I, II and III (A and B) qualifications. Demonstrated proficiency of payer claims projects (Determined by management team and competencies.)
EDUCATION: HS Diploma or equivalency required. 1 year of Lead or Supervisor experience in a medical revenue cycle position is required.
Associate or Bachelor's Degree preferred. College education in business or accounting may substitute for required experience on a year for year basis up to three years.
CERTIFICATION/LICENSES: none required
Knowledge will include at minimum, all aspect of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures
Ability to utilize system reporting, resources and staff feedback to identify trends in claim issues across all payers.
Ability to process skills to develop root cause and corrective guidance for teams and with payer representatives.
Ability to work with payer representatives on project for claims resolutions.
Ability to provide payer representatives with claim details and supporting documentation
Ability to work with revenue cycle staff, coding staff, system analysts, clinic leadership and payer representatives to develop and implement resolutions for trending claim issues.
Must have good organization skills in order to track and document claims issues from identification to resolution.
Must have exceptional verbal and written communication skills in order to present and explain information to internal and external customers and present corrective feedback/constructive criticism in a direct, clear and supportive manner.
Ability to write letters using proper English, grammar, spelling, vocabulary, and punctuation
Must have practical experience with Adobe, Word, Excel and Microsoft Outlook applications. Also, any other computer applications related to the work (document imaging systems, Organizational Share Point, Revenue Cycle systems)
Must have ability to make independent decisions that are generally guided by established procedures.
Must have a desire to learn ethical and compliant business practices.
Must be able to handle sensitive, stressful and confidential situations and account information.
Must have excellent keyboarding and 10-key skill-set.
Must have knowledge to perform functions requiring the use of the Internet.
Willingness and ability to learn new tasks.
Must have communication skills to educate, present, and/or represent Revenue Cycle to other departments, payers, and/or staff.
Skills to provide one on one and team training with employees.
Identification and resolution of deficiencies in training or workflow processes for AR staff, both individual and team.
Expertise in all revenue cycle skills required for Level I, II and III(A and B) (as determined by management)
Quality/Compliance: Achieves a standard of excellence with work processes and outcomes, honoring Organizational policies and all regulatory requirements.
Customer focus: Strives for high customer satisfaction, going out of our way to be helpful and pleasant, making it as easy as possible on the patient, family member or customer rather than our department or organization.
Safety Mindset: Promptly reports or corrects any unsafe condition. Records/reports the need for service maintenance or repair of equipment and removes any faulty equipment from service.
Communication: Balances listening and talking, speaking and writing clearly and accurately, influencing others, keeping others informed.
Collegiality: Is helpful, respectful, approachable and team oriented, building strong working relationships and a positive work environment.
Initiative: Takes ownership of the work, doing what is needed without being asked, following through
Efficiency: Plans, manages time well, is on time, is cost conscious, and thinks of better ways to do things.
Coach-ability: Is receptive to feedback, demonstrates a willingness to learn, and embraces continuous improvement.
Demonstrates an ability to work in a collaborative manner.
Diversity: Acknowledges and respects cultural diversity in all interactions.
Adaptability and flexibility to respond to a rapidly changing work environment.
EXPERIENCE: Minimum of 10 years progressive work experience in Revenue Cycle in the medical field with skills and experience in multiple business office functions or equivalent education. Experience providing educational training either in classroom or one on one with associates required. Two years Revenue Cycle experience in CHRISTUS Facility preferred. Team lead or supervisor experience preferred.
NATURE OF SUPERVISION:
-Responsible to: Manager, Business Office
-Bloodborne pathogen: A
Works in a clean, well-lighted smoke free environment.
PHYSICAL REQUIREMENTS: Long periods of sitting, walking. Must be flexible in work schedule. Subject to stressful situations. Extended use of video display terminal and keyboard utilizing sound ergonomic principles. May be required to push, pull or lift up to 20 pounds.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.