Benefits Investigation Supervisor

FULGENT THERAPEUTICS LLC•Coppell, TX

6d•Onsite

About The Position

Inform Diagnostics, a Fulgent Genetics Company, is looking for an experienced supervisor for the benefit investigation (BI) unit who works well in prioritizing and managing the timely completion of BI requests from patients and clients. The BI supervisor is responsible for a broad range operational support to client services, sales team, IT and the revenue cycle team. The role’s duties include maintenance of an updated fee schedule and standard operating procedures in providing patients different payment options. In this role, the supervisor owns the responsibility of managing daily workflow, prioritizing and organizing tasks, monitoring the performance of staff, and acts as the subject matter expert in all areas of BI.

Requirements

Minimum of 4 years work experience in patient benefits, pre-authorizations and/or billing experience.
Minimum of 5 years of previous supervisory experience.
Understanding of Laboratory reimbursement methodologies and standard payment methodologies.
Knowledge of CPT and ICD-10 and coding.
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Knowledge of and experience with contract payer policies and procedures.
Knowledge of HIPPA compliance.
Proficient in Microsoft Office Suite applications.
Handles multiple tasks simultaneously.
Communicates effectively with all levels of staff.
Maintains composure while working under high pressure.
Demonstrates strong interpersonal skills that foster a positive environment.
Demonstrates flexibility and ability to adapt to change.
Excellent communication, time management, and computer skills.
Must be accurate with attention to detail.
Customer service skills for interacting with medical billing clients and office patients regarding medical claims and payments.
Ability to work well in a team environment.
Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
Problem-solving skills to research and resolve discrepancies in billing data.
A calm manner and patience working with either patients, insurers, or co-workers during this process.

Nice To Haves

Bachelors or Associate Degree is preferred but not required

Responsibilities

Supervises the work distribution and workflow of the BI Team.
Supervises and monitors daily work performance. Including call monitoring, production tracking, attendance, turnaround times, and quality tracking.
Conducts monthly 1:1s with staff and coaches to improve team’s overall performance.
Ability to motivate and engage team while holding them accountable to high standards.
Creates schedules, approves timecards, and PTO requests.
In production as needed.
Conducts new hire and refresher trainings as needed.
Establish priorities and must be able to multi-task so that assigned duties are completed under the pressures of time constraints and deadlines.
Reports employee and department level metrics to senior leadership.
Use of good communication; oral, hearing, and written.
Ensures patient demographic, insurance and referring physician information are accurately entered into system.
Checking that automation of eligibility verification are optimized
Confirming provider credentials with insurance companies and hospitals.
Reviewing patient bills for accuracy and completeness and obtaining any missing information.
Ensures all prepayments are applied on time on self-pay accounts.
Calling insurance companies regarding any discrepancy in patient eligibilities.
Negotiating single case agreements with third party payors.
Acquiring knowledge of medical terminology likely to be encountered in medical claims.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPPA).
Performing other related duties or special projects as assigned.