Supervisor PFS Government Accounts - PFS Billing & Collections - Sharp Corporate - Day Shift - Full Time

Sharp HealthCare • San Diego, CA

8d • Onsite

About The Position

The Supervisor PFS-Government Accounts provides effective leadership through a commitment to offering accurate information and assistance to our department and within our teams in a courteous, convenient, compassionate, and timely manner. Ensures compliance with all rules and regulations for government payers, ensures accurate and timely billing and follow-up to ensure timely filing and appropriate reimbursement. Efficiently and effectively documents information and activities so they can be tracked, trended and utilized for quality improvement initiatives always reflecting the Mission, Values, and Philosophy of Sharp HealthCare.

Requirements

• H.S. Diploma or Equivalent
• 3 Years Experience in hospital patient registration, accounting, and/or business service with demonstrated above standard performance.
• 2 Years Leadership experience.

Nice To Haves

• Bachelor's Degree
• Knowledge of Managed Care Contract Reimbursement, Government Reimbursement and medical terminology preferred.

Responsibilities

• Maintain knowledge base of current government regulations for all affiliated payors through coordination with other team leaders, government websites and other information.
• Centralizing and reviewing all payment and denial material correspondence, EOBs, zero payments on acct, etc., notes in IDX from clinical/financial staff to ensure accurate and appropriate payments in a timely manner.
• Working with other team leaders to identify additional denial write offs as contractual adjustments and ensure appropriate and accurate.
• Promotes and maintains positive working relationships organizationally by providing consultation and collaboration on billing and collection matters.
• Promotes professional and accurate relationships with various internal and external departments.
• Maintains a complex and evolving knowledge of health insurance and Federal and State laws, mandates and regulations.
• Participates in department projects and implementation of new services and products, as requested by Management, may include leading work groups, project management, audits and back-up support to cross department initiatives.
• Maintains continuing education requirements for accreditation.
• Participates in professional activities to keep informed of professional standards.
• Ensures compliance with legal and company policies and procedures.
• Ensures customer issues that might escalate and require a supervisor when manager is not present.
• Designs departmental programs and processes in a manner that most effectively accomplishes assigned goals.
• Oversees departmental activities, monitors productivity and scorecards, and ensures operational efficiency and quality of services.
• Identifies and resolves operational problems and inefficiencies to ensure quality service, achieve required results, and promote staff morale and job satisfaction.
• Trending and analyzing of billing to collections, identifying root causes, working with the manager to identify and resolve system or payer issues.
• Reporting denials by payor, including total open cases, resolved cases and % of individual payors' net receivables.
• Facilitating presentation of findings to management.
• Proposing recommended improvements to reporting Improvements to ensure accurate tracking of denials.
• Works with Account Analyst III on assigned task and projects.
• Works with Manager, to identify training priorities and participate in development of new training programs.
• Under the direction of the Manager and training team, educates the staff on Federal, State, and impending legislative and regulatory requirements as they affect relevant processes.
• Assure that all staff is up to date on accreditations.
• Identifies opportunities for improved efficiency and cost effectiveness, and works with Manager, to design and implements action plans.
• Makes recommendations to the Manager, on process improvements with the goal of enhancing quality.
• Creating reward and recognition programs to motivate the staff to achieve/exceed goals.
• In the absence of, or as directed by, the PFS Manager, this position acts as the direct management interface.
• Provides the PFS team with direction, communication, and leadership for the purpose of achieving/exceeding AR goals set by the department.
• Conducts performance evaluations in a timely manner, hires and counsels staff.
• Works with Manager on implementation of assigned goals including upcoming and ongoing Epic conversion.
• Attends all conversion meetings, discussions and trainings.
• Along with and by direction of the Manager, will make implementation decisions and become subject matter expert for training of new operating systems.
• Researching and successfully implementing best practice strategies to improve organization's financial outcomes thought root cause analysis of denials.
• Documenting action plan.
• Measuring efficacy of newly implemented strategies on a go forward basis and modify if necessary.
• This includes but is not limited to PAS staff, Utilization Management, MDs, PFS staff, IS Billing and contracts department for future negotiations.

Benefits

• Shift Start Time: 9 AM Shift End Time: 5:30 PM
• AWS Hours Requirement: 8/40 - 8 Hour Shift
• Weekend Requirements: As Needed
• On-Call Required: No
• Hourly Pay Range (Minimum - Midpoint - Maximum): $39.690 - $51.220 - $57.370
• The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED