Supervisor, PFS Back End - Remote

Ambry Genetics

29d • $32 - $36 • Remote

About The Position

The PFS Supervisor's main role is to lead the collections team towards department goals of increasing cash collections and improving upon reimbursement rates. This supervisor should have the ability to work any claim, regardless of aging, and must work with both commercial and government payers, review EOB’s and medical policy to evaluate and submit for appeals, as well as perform in-depth research to appropriately obtain coverage for any denied claims. The collections supervisor will also develop and deliver reports to management to summarize payer and claims issues and contribute suggestions for policy and process improvements. This role will take point on implementing process changes within the team, as well as operationally guiding the team on a day-to-day basis to ensure department goals are met.

Requirements

• High school diploma plus some college preferred
• 5+ years’ experience in a clinical laboratory preferred, especially genetic billing
• 5+ years’ experience in working as Supervisor role in Accounts Receivables
• Knowledge of CPT codes, medical terminology, insurance plans, ICD 10 codes
• Must have ability to adapt to a fast paced, dynamic environment
• Must have experience with Practice Management systems, Xifin experience preferred
• Must have excellent computer skills
• Must be able to coach staff and walk employees through collection processes
• Must understand the different payer plans and basic understanding of A/R
• Must be detail-oriented, analytical, and experienced in writing appeals

Responsibilities

• Assists manager with coaching, disciplining, and otherwise managing the performance evaluations and appraisals for all staff in a timely manner as well as ensures that company and departmental employee policies are followed (e.g. Timecard Management)
• Supervises collections team to ensure daily productivity and quality standards are met, as well as assist with training to ensure all team members are operating at full potential
• Create notes on the patients account for auditing and actions taken per the Standard Operating Procedures or as outlined by the team manager
• Works the total patient accounts outstanding A/R including credits and denials to reduce A/R aging buckets per the department’s goals
• Researches and understands different payer policies and reimbursement history to improve ability to successfully overturn claim denials through the claims process
• Understands the various Ambry products and tests and can present reasonable arguments for medical necessity on behalf of the patient to obtain coverage from the insurance payer
• Works hand in hand with the other team members to correct errors, communicate with team members about payer policy updates and improve workflow processes (e.g. billing integrity)
• Send corrected claims and appeals based on payer guidelines in a timely manner
• Manages write-offs or adjustments on accounts when applicable, as well as process refund requests received from payers to determine if payment errors were made
• Develops and delivers detailed reports to management regarding overall payer issue to support denial management and works to resolve issues at both the claim and payer levels
• New hire training
• Other projects as assigned
• Other duties as assigned

Benefits

• Our outstanding benefits program includes medical, dental, vision, FSA, paid sick leave and generous paid time off (PTO) program.
• The Company reserves the right to make changes to the 401k plan from time to time.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees