Supervisor Revenue Cycle Financial Clearance

Monument Health•Rapid City, SD

16d

About The Position

Under the general direction of the Revenue Cycle Manager, the Supervisor performs a variety of complex duties and supervision of financial clearance and/or registration personnel and activities to ensure the efficient processing of patients. Coordination of daily activities for Patient Services Center, including but not limited to scheduling of staff, maintenance of work queues, and statistical reporting. Demonstrates ongoing growth and development of self through active self-reflection, personal competency development strategies, and role modeling the “Grow myself, grow my team, and grow Monument Health (G3) Leadership Competencies” to promote our Monument Health vision and mission. Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include: Supportive work culture Medical, Vision and Dental Coverage Retirement Plans, Health Savings Account, and Flexible Spending Account Instant pay is available for qualifying positions Paid Time Off Accrual Bank Opportunities for growth and advancement Tuition assistance/reimbursement Excellent pay differentials on qualifying positions Flexible scheduling

Requirements

Education - High School Diploma/GED Equivalent in General Studies
Certification - Certified Healthcare Access Associate (CHAA) - National Association Healthcare Access Management (NAHAM) or Certified Healthcare Access Management(CHAM) - National Association Healthcare Access Management (NAHAM) within one year of hire.

Nice To Haves

Education - Associate degree in Business, Healthcare, or related field
Experience - 3+ years of Admissions, Registration and/or Billing
Experience - 1+ years of Supervisor Experience

Responsibilities

Directly oversees staff members and is responsible for ensuring their work output is satisfactory and their concerns are resolved. This includes conducting routine staff audits for productivity and tracking results.
Monitors registration and financial clearance processes to ensure high quality customer service.
Identifies problem areas and develops plan of action to ensure benchmark standards are obtained and maintained.
Leads workflow efforts for assigned area; analyzing, reassigning, and adjusting based on work needs.
Maintains strict confidentiality regarding patient’s personal, medical, and financial information.
Maintains knowledge of industry and payer regulations and system software.
Ensures the financial clearance process for areas of responsibility is completed timely and accurately prior to patient arrival by monitoring work queues and reports to ensure appropriate productivity and quality standards.
Demonstrates an understanding of technical denial areas, such as: medical necessity, eligibility issues, coding issues, no authorization, and timely processing of claims.
Maintains knowledge of core revenue cycle functions such as billing, claims filing, data entry, charge entry, insurance follow up, denial management, payment posting, customer service, and billing records review to support duties related to preservice financial clearance and resolution of related denials.
Understanding of fund finding, Provides escalated customer support service.
Acts as a liaison for both internal and external customers to inform financial clearance processes and role in aiding scheduling of care and claims submission and resolution.
Analyzes, assists, and resolves problem claims through the management of follow up and denial work queues for areas of responsibility.
Contacts patient, guarantors, and/or third-party organizations to secure information; prepares and maintains patient coverage records to assist in the adjudication of claims.
Participates in and leads payer and or departmental meetings.
Responsible for providing feedback, suggestions, and process improvement recommendations to manager and above.
Promotes a culture of accountability, teamwork, collaboration, and operational excellence in holding with organization mission, vision, and values.
Responsible for all hiring and related personnel decisions, completing routine performance review evaluations, training, scheduling, and process documentation in collaboration with Manager.
Meets regularly with direct reports to review accomplishments and set goals.
All other duties as assigned.