Summary:
Under general direction of the PFS Manager the Supervisor of Patient Financial Services assists in the day-to-day activities of Patient Financial Services claims administration. Organizes directs and controls follow up activities for Brown University Health and affiliates for inpatient outpatient and Hospital billed physician claims for all insurance payers. Assists in identifying opportunities and implementing change within department guidelines federal and state regulatory requirements resulting in the improvement of the accounts receivable cash flow and denial reduction.

Responsibilities:
Interviews directs and evaluates support staff provides guidance and counsel. Orients new staff assigns work and establishes priorities. Establishes annual performance objectives for staff conducts periodic performance reviews and recommends pay actions.



Develops and communicates standards and expectations for staff performance. Provides direction in day-to-day operations implements approved follow up procedures monitoring the quality of work performed by staff ensuring services are provided in accordance with 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. As appropriate recommends corrective action to Director up to and including termination



Ensures all procedures are compliant with applicable Federal and State regulations. Initiates requests for system updates as appropriate to comply with such regulation and payer requirements.



Functions as key resource to staff in resolving complex issues. Assigns work ensuring equitable distribution of same by maintaining related productivity reports and monitoring assigned work queues. Serves as expert resource for questions that need to be escalated because of complexity payer issue or customer complaints and concerns.



Develops and maintains process documentation and tip sheets. Provides/coordinates initial training of new staff in activities related to systems utilized by department. Identifies training needs through observation of staff work output customer feedback and develops action plan. Obtains approval by Manager or Director implements and assesses effectiveness accordingly.



Maintains issues logs for individual payers as appropriate. Meets with internal/external representatives (e.g. third party payers and Brown University Health departments) to discuss and resolve claim and denial issues changes in process and the like. Monitors payer contracts within area of responsibility to identify communicate and resolve claims adjudication issues. Within level of authority extended by management authorizes adjustments in accordance with department policy.



Provides support to Manager in compiling documentation needed to respond to internal and external audits.



Assists Manager in compiling and developing reports of various statistics needed for follow up activities. Analyzes and monitors receivable data to report status trends and variances. Monitor revenue cycle for potential opportunities risks delays and initiates action to resolve.



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.



Attends/conducts meetings in the Manager�s absence.

Other information:
BASIC KNOWLEDGE:

High school graduate with knowledge of medical business office practices human resource management/training proficient in medical systems and additional training or experience in healthcare billing/coding.



Associate�s degree in accounting business office practices or computer science preferred.



EXPERIENCE:

Five to ten years senior level or supervisory experience in patient accounting at a multi-facility healthcare system environment.



Experience and knowledge in the use of software applications databases and spreadsheets.



Knowledge of third party payment issues as well as effective communication organizational human resource and leadership skills.



Must be familiar with 835 file formats.



Knowledge of Access Database management Epic and Emdeon.



Desired: Epic HB and PB payment



SUPERVISORY RESPONSIBILITY:

Direct supervision for up to 10 full-time equivalent personnel



Work is performed in a typical office setting requiring extensive sitting.



Position requires ability to speak see and hear within normal range.

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Brown University Health is a VEVRAA Federal Contractor.

Location: Brown University Health Corporate Services USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union

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