Commercial Follow-Up/Denials Supervisor - HB Patient Financial Services - FT Days

University of California, Irvine•Anaheim, CA

10h

About The Position

Position Summary: Commercial/Managed Care Collection/Denial Manager, the Commercial/Managed Care Collection/Denial Supervisor is responsible for overseeing operations and providing support and guidance to the collection unit. Strong working knowledge of hospital billing and collections of Commercial, Managed Care, Federal/State/County & Self-Funded reimbursement and other programs. As a coach and mentor, provide training, address performance issues, manage compliance, and ensure competency in accordance with established standards, procedures, policies, and legal requirements. Contribute to a work environment that fosters positive morale and ensures compliance. Research and investigate issues as needed, analyze and resolve problems and discrepancies, provide creative solutions, and recommend alternatives and initiatives to optimize performance. Work collaboratively and assist in personnel actions and staffing and human resource matters. Assist in the development of unit goals and objectives and on special projects as needed. Performs routine analysis of various key performance indicators, dashboards, and reports to optimize performance and maintain positive A/R disposition.

Requirements

Strong working knowledge of hospital billing, manage care, fed/state/county & self funded reimbursement
Strong analytical skills to effectively comprehend multiple reports and analyze array into actionable form
Strong analytical and report writing skills to effectively comprehend multiple reports and analyze array into actionable form
Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties.
Must possess leadership skills. Must be able to identify potential problems and resolve them as needed.
Must possess effective time management and organization skills
Must have working experience in billing and collections of Commercial, Managed Care, Medicare, Medicare Advantage, Medi-Cal, CalOptima, FQHC, and CCS, fed/state/county & self-funded reimbursement and other programs that fall under the scope of Comm/Mgd Care programs and commercial billing.
Must have the ability to maintain a pace appropriate to the workload.
Must have knowledge of DHMC, Federal and State regulatory guidelines and claims management.
Must have experience in using computers and related programs (i.e., Microsoft, Excel, Outlook, PowerPoint, etc.).
Must demonstrate strong technical knowledge of CPT, HCPS and ICD-10 coding, LCD, NCD, MUE, CCI, Modifiers, authorization requirements and related documentation
Must be able to facilitate accurate and timely billing and collections
Minimum one( 1) year prior experience leading or overseeing a team.
Knowledge of Invision, TDS, Access, Excel, Word, HCC, and billing systems
Excellent oral/written communication, judgement, and decision-making skills with ability to function independently and as a member of a team.
Excellent oral and written communication skills. Ability to develop summaries/reports on billing activities
Excellent judgment for decision-making requirements.
Excellent interpersonal communication skills to communicate effectively with external contacts to include Admissions, Information Systems Management, clearing house vendors, and insurance companies
Bachelor's Degree and three (3) years of related relevant experience in business office operations, consulting, or auditing; or an equivalent combination of education and experience.

Nice To Haves

Prior experience with and working knowledge of EPIC electronic health record
Knowledge of university and medical center organizations, policies, procedures, and forms

Responsibilities

Overseeing operations and providing support and guidance to the collection unit.
Provide training, address performance issues, manage compliance, and ensure competency in accordance with established standards, procedures, policies, and legal requirements.
Research and investigate issues as needed, analyze and resolve problems and discrepancies, provide creative solutions, and recommend alternatives and initiatives to optimize performance.
Work collaboratively and assist in personnel actions and staffing and human resource matters.
Assist in the development of unit goals and objectives and on special projects as needed.
Performs routine analysis of various key performance indicators, dashboards, and reports to optimize performance and maintain positive A/R disposition.