Commercial Follow-Up/Denials Supervisor - HB Patient Financial Services - FT Days

Commercial Follow-Up/Denials Supervisor - HB Patient Financial Services - FT Days

Req ID: 140949

Location: Anaheim, California

Division: Medical Center

Department: HB Patient Financial Services

Position Type: Full Time

Salary Range Minimum: USD $71,600.00/Yr.

Salary Range Maximum: USD $127,400.00/Yr.

Who We Are

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.

To learn more about UCI Health, visit www.ucihealth.org.

Your Role on the Team

Position Summary:

Commercial/Managed Care Collection/Denial Manager, the Commercial/Managed Care Collection/Denial Supervisor is responsible for overseeing operations and providing support and guidance to the collection unit. Strong working knowledge of hospital billing and collections of Commercial, Managed Care, Federal/State/County & Self-Funded reimbursement and other programs. 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.

What It Takes to be Successful

Required Qualifications:

• Strong working knowledge of hospital billing, manage care, fed/state/county & self funded reimbursement
• Strong analytical skills to effectively comprehend multiple reports and analyze array into actionable form
• Strong analytical and report writing skills to effectively comprehend multiple reports and analyze array into actionable form
• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties.
• Must possess leadership skills. Must be able to identify potential problems and resolve them as needed.
• Must possess effective time management and organization skills
• Must have working experience in billing and collections of Commercial, Managed Care, Medicare, Medicare Advantage, Medi-Cal, CalOptima, FQHC, and CCS, fed/state/county & self-funded reimbursement and other programs that fall under the scope of Comm/Mgd Care programs and commercial billing.
• Must have the ability to maintain a pace appropriate to the workload.
• Must have knowledge of DHMC, Federal and State regulatory guidelines and claims management.
• Must have experience in using computers and related programs (i.e., Microsoft, Excel, Outlook, PowerPoint, etc.).
• Must demonstrate strong technical knowledge of CPT, HCPS and ICD-10 coding, LCD, NCD, MUE, CCI, Modifiers, authorization requirements and related documentation
• Must be able to facilitate accurate and timely billing and collections
• Minimum one( 1) year prior experience leading or overseeing a team.
• Knowledge of Invision, TDS, Access, Excel, Word, HCC, and billing systems
• Excellent oral/written communication, judgement, and decision-making skills with ability to function independently and as a member of a team.
• Excellent oral and written communication skills. Ability to develop summaries/reports on billing activities
• Excellent judgment for decision-making requirements.
• Excellent interpersonal communication skills to communicate effectively with external contacts to include Admissions, Information Systems Management, clearing house vendors, and insurance companies
• Bachelor's Degree and three (3) years of related relevant experience in business office operations, consulting, or auditing; or an equivalent combination of education and experience.

Preferred Qualifications:

• Prior experience with and working knowledge of EPIC electronic health record
• Knowledge of university and medical center organizations, policies, procedures, and forms