Supv PFS

Brown MedicineBaltimore, MD
Hybrid

About The Position

Under the general direction of the Manager, Billing and Provider Enrollment and the Director, Revenue Cycle, the Supervisor of Provider Enrollment is responsible for planning, directing, coordinating, and controlling the operations and activities of Provider and Facility Enrollment for Brown University Health and related entities hospital and professional services. This position is responsible for the daily supervision of the Provider Enrollment team. This role is also responsible for enrolling providers/facilities with our government and commercial payors. The Supervisor of Provider Enrollment hires and directs the work of and evaluates the performance of Provider Enrollment staff. Supervisor of Provider Enrollment prepares and presents various statistical reports and budget justification requests; assists the Director in establishing departmental policies, programs, and procedures; and evaluates, initiates, and implements various departmental systems and procedures and revises these as necessary to maximize efficiency. This position also assesses personnel and fiscal implications of organizational changes of these programs; assists staff in implementation of changes; monitors and analyzes the impact of change. Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate In addition, our leaders will demonstrate an aptitude for: Ensure Accountability and Build Effective Teams Drive Vision and Purpose and Optimize Work Processes By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.

Requirements

  • Associates degree in business administration, finance or related field, or equivalent related experience.
  • Problem-solving skills
  • Time management skills
  • Strong written and verbal communication skills
  • An uncompromised level of patience, compassion, and empathy.
  • The ability to identify, analyze, and interpret trends or patterns in complex data sets to meet business needs.
  • Current knowledge of NCQA and Medicare credentialing standards and other regulatory requirements.
  • Knowledge of credentialing principles for provider networks/payers.
  • Intermediate computer skills, credentialing software and information systems knowledge; ability to generate management and production reports, documents and correspondence independently.
  • Coaching, training, and troubleshooting customer needs.
  • Guiding new staff through the onboarding process and a strong training program.
  • Supporting existing staff when they have questions or need help updating their system configurations.
  • Determining the personal and professional goals of individual staff and identifying potential challenges.
  • Performing progress assessments and utilizing motivation techniques.
  • Pursuing continued professional development and keeping abreast of advancements in the field.
  • Two to three years progressively more responsible related experience in patient finance in a similarly complex healthcare organization.
  • Experience must demonstrate knowledge in variety of software applications, including access database, data warehouse system and patient finance systems.
  • Must demonstrate effective interpersonal and organizational skills, including ability to communicate concepts for automated processes and written communication.
  • Experience must also demonstrate effective customer service skills and ability to effectively resolve technical problems.
  • Customer service supervisor duties and responsibilities are keeping the balance between their employees and customers skillfully and prudently to ensure success.

Responsibilities

  • Provides direction in day-to-day operations of customer service, operation support and self-pay analysis functions related to updating and auditing patient accounting records, on-line E-payment system, requests for billing-related medical record notes (i.e. lab reports, clinic reports) and varied customer service research activities to reconcile issues raised by patients and other Brown University Health departments.
  • Partnering with different stakeholders to keep them informed about upcoming data management initiatives.
  • Designing, developing, and modifying data infrastructure to accelerate the processes of data analysis and reporting.
  • Reviewing presentations, manuscripts, graphs, and tables to ensure accuracy and quality.
  • Developing standards of operation when handling and archiving data.
  • Maintaining data management plans and instructions for operating complex business systems.
  • Overseeing the integration of new technologies and initiatives into data standards and structures.
  • Evaluating the design, selection, and implementation of database changes by comparing them with business requirements and design documents.
  • Assessing system performance and making recommendations for hardware, software, and data storage improvements.
  • Liaising with internal stakeholders and follow up with external customers on all account related requests.
  • Identifying and driving process improvements to ensure excellence in customer experience, timely delivery of services, optimum productivity, and effective management of resources.
  • Participates with director in recruitment, interview, and selection activities of support staff.
  • Orients new staff, assigns work, and establishes priorities.
  • Establishes annual performance objectives for staff, conducts periodic performance reviews and recommends pay actions.
  • As appropriate, recommends corrective action to director, up to and including termination.
  • Develops and communicates standards and expectations for staff performance.
  • Monitors quality of work performed by staff, ensuring services are provided according to established procedures and carried out in prompt and courteous manner to meet/exceed customer service standards.
  • Ensures staff is apprised of changes in policy and procedures that relate to area of responsibility, ensuring adherence to same.
  • Monitors customer service telephone calls for accuracy of information provided and quality control purposes.
  • Maintains issues/resolution logs for department as appropriate.
  • Develops and maintains process documentation.
  • Provides initial training for outside vendors and new staff members in activities related to receivables systems utilized by department.
  • Identifies training needs through observation of internal and external agency staff, customer feedback and develops action plan; obtains approval by director and implements and assesses effectiveness accordingly.
  • Functions as resource to staff, providing guidance in completing daily responsibilities and addressing more complex or sensitive issues.
  • Serves as expert resource for questions that have to be escalated because of complexity or patient complaints and concerns.
  • Regularly conducts individual and group meetings for department.
  • Documents payroll for subordinate staff.
  • Maintains vacation schedules and authorizes time off for staff.
  • Adjusts coverage for vacation time and breaks as workflows fluctuate.
  • Participates in development and implementation of patient financial services customer service policies.
  • Provides input for preparation of annual operating budget for area of responsibility.
  • Assists manager in responding to internal and external audits, as well as preparation of related reports, files and documents as required.
  • Prepares and maintains a variety of reports and records to support outcome measures related to staff, projects and system performance.
  • Regularly meets with director to maintain awareness of department activities and issues encountered.
  • Reviews processes related to programming and auditing of automated account files for outside pre-collect and collection agency vendors’ activities for self-pay and bad debt receivables.
  • Obtains clarification from self-pay analyst group as necessary.
  • Performs regular audits on departmental automated processes, implementing controls when necessary to ensure consistent compliance with HIPPA, regulatory standards, tracking and reporting requirements.
  • Maintains knowledge of Fair Debt Collection Act and related regulatory standards through participation in training programs and seminars.
  • Develops, implements, and maintains policies and procedures to facilitate tracking and fulfillment of subpoenas requesting information or documentation as maintained in electronic/paper records as served upon departments.
  • Accepts subpoenas and coordinates with internal/external sources for subpoena fulfillment.
  • Recommends changes to system security group to ensure access to systems is appropriate for various job groups.
  • Works collaboratively with other departments to coordinate activities, respond to inquiries, foster collaboration, and facilitate meeting organizational needs.
  • Ensures adequate office supply inventories are maintained and that department equipment is in good working order to support department activities.
  • Performs other duties as assigned.
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