Payer Compliance Supervisor

US-TX-Dallas
Job ID
2017-1578
Function
Revenue Cycle Management
Employment Status
Full-Time

Overview

Provides staff supervision and support to Team Leads and AR associates. Compiles and produces daily, weekly and monthly reports to management as requested.  All new hires must submit to and pass a pre-employment drug screen and background check.

Responsibilities

  • Compiles and types reports, creates and works spreadsheets in order to assist Manager with research and analysis of PCM trends.
  • Regularly track and monitor productivity and accuracy of staff members. Work to ensure ongoing follow up and communication with each employee in order to keep them aware of the standards of performance expectations, (Audit Process). Maintain reports with daily, weekly, monthly and YTD data. Incorporate data into annual performance review process and quarterly bonus calculations.
  • Monitor ETM queues and work to provide ongoing staff supervision and training.
  • In conjunction with PCM Manager and Training department, provide training and on-going education for all staff members as well as assist with annual reviews.
  • Work with HR on recruiting issues and interviews of prospective employees.
  • Provides assistance in performing monitoring and analysis of the PCM System, active inventories, work assignments, workflows, backlogs, identifies negative trends and staffing levels.
  • Encourages employees to improve their skills and to expand their expertise.
  • Ability to manage multiple tasks and work independently with high level of accuracy
  • Identifies and helps develop strategies to resolve problems impacting an efficient revenue cycle.
  • Enforces company policies as well as rules and guidelines of the Payer Compliance Dept.
  • Monitor staff attendance, provide counseling as appropriate.
  • Resolve personnel issues in conjunction with PCM Manager and Human Resources.
  • Acts as an effective liaison with management and line staff in other departments as needed to address problem areas and assist with resolution.
  • Maintain OSHA and HIPAA compliance.
  • Delegate work as necessary to stay current with priority tasks.
  • Maintains strictest confidentiality
  • Performs other duties as assigned

Qualifications

JOB REQUIREMENTS (Knowledge, Skills and Abilities):

  • Excellent Verbal and Written skills
  • Ability to prioritize work
  • Strong analytical skills; ability to gather, analyze and report on information from multiple
  • sources (i.e., Billing System, Internet, Payer Contracts)
  • Skilled in calculating charges, payments and adjustments per established guidelines
  • Knowledge of managed care contracts
  • Excellent verbal and written communication.
  • Ability to work effectively and independently with staff, physicians and external customers
  • In-depth knowledge of Medicare, Medicaid, Workers Compensation guidelines and billing standards
  • In-depth knowledge of patient accounting systems and the ability to adapt prior knowledge to current software
  • In-depth knowledge of financial class setup and payer setup
  • Ability to work effectively and independently with staff, physicians, and external customers
  • Must have strong computer skills with knowledge of Microsoft Word, Excel and PowerPoint
  • Must have a pleasant disposition and high tolerance level for diverse views and opinions
  • Ability to work independently with minimal supervision
  • Ability to motivate diverse personalities within the departments
  • Communicate well with the public
  • Ability to read, write, and speak English

EDUCATION/TRAINING/EXPERIENCE:

  • A minimum of a high school diploma is required.  Associate’s or Bachelor’s degree in a business or health related field highly preferred 
  • Prefer a minimum of 2 years of experience in Payer Contracting, Managed Care, Reimbursement or but related Revenue Cycle experience will be considered 
  • A minimum of three to five years prior supervisory experience in medical billing and collections preferred

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