Pre-Arrival Supervisor - Pre-Arrival - Full Time 8 Hour Days (Exempt) (Non-Union)

Keck Medicine of USC•Los Angeles, CA

3d•$68,640 - $112,370•Onsite

About The Position

This position supervises daily teams of staff to ensure all aspects of financial clearance (contract status, patient demographics, insurance verification, authorization and coverage for services, pre-estimation of patient liability pre-service patient contact and collections) are consistently and accurately performed to support a defect-free account. The Supervisor monitors the volumes, throughout, staff productivity, quality; anticipate necessary shifts to support team and outcomes. Oversees staff time and attendance within department standards. The Supervisor provides team cohesiveness, direction and education/ training to the teams. This position establishes and monitors workflow processes that accelerate financial clearance for patients and streamlines system operations. The Supervisor will routinely be tasked with creating written workflows, protocols and process improvement plans to benefit financial clearance throughput and to increase responsiveness to clinical staff requests, this position will be a primary contact for clinical departments and leaders to address specific patient needs or routinely meet with departments on processes and outcomes. This position will participate and assist management with strategic planning to address volume growth, system and workflow changes, gaps in coverage, staff under performance, lapse in turnaround times and other issues, which impede prompt service.

Requirements

High school or equivalent Diploma or transcript required for file.
3 years Experience in insurance verification, authorization and/or revenue cycle management.
Demonstrates advanced knowledge and experience in financial clearance.
Demonstrates excellent verbal and written skills and advanced knowledge of hospital systems as they relate to financial clearance and insurance.
High content knowledge of medical terminology.
Demonstrated ability to problem-solve and provide effective resolution.
Possess strong analytic skills and be able to evaluate and analyze data—using it to drive process improvement and impact positive change and outcomes.
Demonstrated leadership skills and ability to provide education and support to staff.
Possess strong analytic skills and be able to evaluate and analyze data
In-depth knowledge and experience of transplant finance, insurance & health plans/medical groups, transplant authorizations and the financial clearance process.
Excellent verbal and written communication skills, along with a high command of hospital and transplant IT systems as they relate to financial clearance and insurance.
Knowledge of the transplant process and patient demographics is an essential function of the role.
Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

Nice To Haves

Associate's degree
Bachelor's degree in related field.
Bilingual fluency is strongly.
Bilingual strongly preferred; if bilingual certified department translator strongly.

Responsibilities

Oversees the accuracy of the data entry of demographic and insurance information obtained by staff for patient registration.
Investigate errors, develop processes and/ or lead changes in the workflow process; and/or, implement solutions to encountered problems.
Monitors accuracy of scheduling functions, provider templates and makes recommendations on template changes to best utilize providers time, while ensuring patient satisfaction.
Manage assigned team processes and workflow to ensure financial clearance of assigned accounts that minimize patient disruption of services. Enforces established policies and procedures, including work rules, safety procedures, confidentiality standards, JCAHO standards and CMS standards.
Oversees work queues and reports to ensure accurate and timely registration, scheduling and claims submission.
Maintains a solid understanding and knowledge of payer requirements, registration and scheduling workflows, as well as referral requirements to ensure staff follows established procedures to maximize reimbursement.
Tracks common issues and provide training to staff to prevent the issue from reoccurring.
Gather and analyze departmental and program specific productivity and quality of service statistics.
Work collaboratively with health counterparts, Patient Financial Services, and other departments on issues relating to patient registration, scheduling, patient flow, insurance verification, referrals and reimbursement issues.
Represent the department in meetings and on committees relating to these issues. Represents team in meetings with clinical areas to drive performance and outcomes
Serve as the knowledge expert and information source for staff. Keep abreast of insurance, referral, and billing requirements.
Request system enhancements as needed to facilitate accurate registration and scheduling.
Serve as an escalation point for patient issues and questions. Assist staff with complex and disgruntled patient situations requiring intervention from a higher authority. Escalates matters and interface with leadership as needed. Steps in to assist with backlog as needed to model excellence in service.
Participate in process improvement teams as assigned. Assist with application implementation, upgrades, enhancements, and usability testing. Participate and assist with strategic planning to address volume growth, change, gaps in coverage, underperformance, lapse in turnaround times and other financial barriers that impede prompt service.
Provide information for budget preparation.
Meet and exceed all productivity and quality outcomes.
Monitors and tracks team performance to identify gaps in coverage and helps to implement resolutions to resolve shortfalls.
Effectively uses data to evaluate and analyze real-time production in order to drive process improvement and advance outcomes.
Maintain knowledge of policies and procedures.
Provides direction to staff requiring assistance; guides staff in organizing daily tasks and resolving challenging financial clearance scenarios.
Develop staffing calendars and assure staffing needs are met. Implement alternative staffing patterns as needs arise, taking into consideration department budgetary constraints and performance requirements and restrictions.
Participate and assist in the interview and hiring process to maintain adequate staffing in the department.
Provides training and educational resources to the financial team—exemplifying mastery of Insurance verification and authorization submission
Review and process time cards in an accurate and timely manner. Maintain accurate employee attendance files.
Encourage and commend staff for excellent performance.
Together with the Department Manager: Provide timely performance improvement feedback and coaching. Discipline staff when warranted by inappropriate employee behavior or inadequate work performance. Conduct timely training assessments, reclassification exams, and performance reviews. Participate in conducting team meetings to apprise staff of changes and to address broader-based program area issues and initiatives.
Respond to employee questions/concerns on an individual basis as needed.
Self-directs activities and demonstrates an ability to problem-solve and escalate issues using analytical, written and verbal skills.
Participate in on-call rotation for off-hours staffing issues, escalations, and staff questions.
Develop, recommend and implement policies and procedures for the department.
Monitor adherence to policies and established procedures. Propose methods that assure effective execution of program responsibilities.
Update policy and procedure manuals as required. Apprise staff of changes.
Performs other duties as assigned.