PURPOSE OF THIS POSITION

The PFS Facility Billing Supervisor is responsible for overseeing the claims management and insurance follow-up processes. This Supervisor works closely with the PFS Billing Manager to manage the overall direction, coordination, education and evaluation of staff members. This role also supervises staff to ensure quality performance of goals and promotes awareness of organizational and departmental policy and procedure in accordance with federal, state, and local guidelines.

JOB DUTIES/RESPONSIBILITIES

Duty 1: Plans and coordinates various administrative support functions and daily workflows associated with billing and insurance follow-up; accepts and passes down directions received from the department Managers/Director and/or Hospital Administrators. Duty 2: Establishes staff schedules along with payroll activities, assigns necessary daily duties, provides guidance, education & instruction and ensures staff maintain appropriate workloads to achieve overall organizational goals. Duty 3: Ensures staff are actively and appropriately communicating with payers regarding delayed claims to promote timely reimbursement. Works with staff to resolve and follow up on challenging, problematic, and unresponsive accounts as necessary; escalates critical or ongoing issues to manager in an organized fashion for monitoring. Duty 4: Acquires and maintains knowledge in departmental functions and can provide end user support in day-to-day operations and job functions as necessary.  Duty 5: Reviews and monitors outstanding AR to identify trends that qualify for improvement initiatives; communicates with payers to resolve issues and foster working relationships. Duty 6: Maintains knowledge of industry data and regulatory changes; ensures staff are appropriately educated about and compliant with payer guidelines, state and federal regulations, and industry updates. Works with manager to develop, review and revise policies and procedures to maintain the efficacy of the department. Duty 7: Assists with pulling data, updating metrics, productivity tracking and KPI monitoring. Establishes departmental objectives and works with staff to set individual goals; monitors staff performance, performance reviews and compiles productivity reports for manager. Duty 8: Organizes and leads staff huddles and general meetings for managing daily tasks, issues and improvements. Communicates any operational changes and/or improvement initiatives to follow-up staff; provides education and training as needed. Duty 9: Fosters collaborative departmental environment that encourages teamwork, communication, and performance with reward and recognition. Duty 10: Meets regularly with PFS leadership and leadership from other departments to review performance, align strategies, identify best practices, and improve overall insurance collections that benefits the organizational initiatives. Duty 11:  Creation, participation and/or implementation of projects as assigned by manager or director. Maintains leadership of those projects until finalization occurs. Presents, implements, and educates changes as an end result of those projects. Duty 12: Oversees recruiting, hiring, and training practices; monitors and measures performance of staff. Solicits feedback from end users to assist with planning future training, coordination of upgrades, and prioritizing the need for system enhancements. Supports associate engagement efforts. Duty 13: Assures confidentiality of patient information. Adhere to all aspects of Patient Financial Services including but not limited to HIPAA related privacy, security, transaction, and code set regulations. Must have the ability to remain compliant in all aspects of payer guidelines and regulations that create a compliant claim form and collections of outstanding balances. Duty 14: The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

REQUIRED QUALIFICATIONS

High school graduate or equivalent Associate’s degree in business, healthcare management or 3-4 years Revenue Cycle related experience required 1-2 years of supervisory experience and/or related position with increasing responsibilities related to managing staff and leading teams CPFSS & CRCL certifications required within 12 months of hire Demonstrated knowledge of claims review and analysis; ICD-10, CPT and HCPCS coding; medical terminology and an understanding of HIPAA requirements Ability to interpret payer guidelines, reimbursement, follow-up, and collections practices and experience working with third-party and governmental payers Mastery of desktop applications including MS Office (Word, PowerPoint, Excel and Access) and database management applications. Advanced use of Microsoft Excel required with the ability to analyze, collect, and interpret data trends; identify opportunities for improvement; and develop and implement policies and procedures. Ability to perform project work which may require independent work or collaboration with leaders from other departments; dependable with a high level of initiative, meets commitments, accepts accountability, embraces change, builds strong relationships and stays focused under pressure Ability to coordinate, direct, and supervise the work of others; manage multiple tasks and complex issues with excellent time management & organizational skills Demonstrated leadership, interpersonal, problem solving and communication skills with excellent self-direction and creative solutions for operational efficiencies Adapts positively to changes in the working setting with ease with the ability to educate adult learners A valid driver's license is required (if you do not have a valid Ohio driver’s license you must obtain one within 30 days of your residency in the state).  You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle.          Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department. The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient status.  Must be able to interpret the appropriate information needed to identify each patient’s requirements relative to their age-specific needs and to provide the care needed as described in the area’s policies and procedures

PREFERRED QUALIFICATIONS

Bachelor’s degree CPC certification

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent activities in walking, lifting, bending, squatting, climbing, kneeling, and twisting. The associate will be required to sit for five hours a day. The individual must be able to lift ten to twenty pounds and reach work above the shoulders. This position requires corrected vision and hearing in the normal range. The individual must have excellent eye-hand coordination and verbal communication skills to perform daily tasks.

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