Commercial Follow-Up/Denial Supervisor - HB Patient Financial Services - FT Days
Under the general direction of the Comm/Mgd Care Collection/Denial Manager, the Comm/Mgd Care Collection/Denial Supervisor is responsible for overseeing operations and providing support and guidance to the unit. As a coach and mentor, provide training, address performance issues, manage compliance, and ensure competency in accordance with established standards, procedures, policies, and legal requirements. Contribute to a work environment that fosters positive morale and ensures compliance. Research and investigate issues as needed, analyze and resolve problems and discrepancies, provide creative solutions, and recommend alternatives and initiatives to optimize performance. Work collaboratively and assist in personnel actions and staffing and human resource matters. Assist in the development of unit goals and objectives and on special projects as needed. Performs routine analysis of various key performance indicators, dashboards, and reports to optimize performance and maintain positive A/R disposition.
Required Qualifications:
- Strong working knowledge of hospital billing and collections, managed care, fed/state/county & self funded reimbursement
- Strong technical knowledge of CPT, HCPS and ICD-10 coding, LCD, NCD, MUE, CCI, Modifiers, authorization requirements and related documentation
- Strong knowledge of medical and insurance terminology, billing, and collections procedures and regulations
- Strong interpersonal skills to communicate effectively and work collaboratively with all constituent groups
- Strong decision-making and critical thinking skills, with the ability to analyze and evaluate complex and/or difficult problems, determine appropriate level of intervention, and develop and apply viable solutions
- Resourcefulness to identify and search for information that is not readily available
- Proficient in Microsoft Office and related programs (i.e. Microsoft, Excel, Outlook, PowerPoint, etc.)
- Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
- Must demonstrate customer service skills appropriate to the job
- Minimum one (3) year prior experience leading or overseeing a team
- Minimum of three (3) years of experience in billing and collections of Commercial, Managed Care, Medicare, Medicare Advantage, Medi-Cal, CalOptima, FQHC, and CCS and other programs that fall under the scope of Government programs and commercial billing
- Minimum of four (4) years of related relevant experience in business office operations, consulting, or auditing
- Knowledge of human resources management policies, with the ability to evaluate and document human resources matters and performance
- High degree of professionalism to recognize the need for discretion and maintain confidentiality
- Excellent written and verbal English communication skills
- Demonstrated skill to convey complex information in a clear and concise manner
- Demonstrated effective time management and organizational skills
- Demonstrated ability to work collaboratively and maintain a calm and professional demeanor under difficult circumstances
- Demonstrated ability to use sound judgment
- Demonstrated ability to facilitate accurate and timely billing and collections
- Bachelor's degree in related area and/or equivalent experience/training.
- Advanced analytical and report writing skills to effectively comprehend multiple reports and provide comprehensive assessment of data
- Ability to supervise, schedule, and coordinate daily activities of subordinate staff and effectively manage multiple priorities in a fast-paced, dynamic environment.
- Ability to maintain a work pace appropriate to the workload
- Ability to function independently and as a member of a team
- Ability to establish and maintain effective working relationships across the Health System
- Ability to coach, effectively motivate, and improve staff performance and provide thorough and accurate review of work performance
Preferred Qualifications:
- Prior experience with and working knowledge of EPIC electronic health record
- Knowledge of University and Medical Center organizations, policies, procedures and forms
We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.
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