Provides staff supervision and support to Payer Compliance Management 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.
- Provide detailed monitoring and analysis of the Insurance Underpayment (PCM) System. Manage and monitor fee schedule and ruleset updates, monitor active inventories, monitor staff work assignments, evaluate workflow efficiency, identify department backlogs, identify negative payer trends, root cause known issues and resolve as quickly as possible.
- Monitor Inventory and employee worklists (ETM queues) to ensure invoices are being reviewed for adequate and timely reimbursement, in addition to providing ongoing staff supervision and training.
- Compile reports, create and work spreadsheets in order to assist Manager with research and analysis of reimbursement trends.
- Ensures that large payer appeal projects are submitted consistently and timely with adequate report-outs to leadership.
- 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. Maintain reports with daily, weekly, monthly and YTD data. Incorporate data into annual performance review process and quarterly bonus calculations.
- In conjunction with Department Manager and Training department, provide training and on-going education for all staff members and assist with annual reviews.
- Work with HR on recruiting issues and interviews of prospective employees.
- 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 Underpayments Dept.
- Monitor staff attendance, provide counseling as appropriate
- Resolve personnel issues in conjunction with department 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
- 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 5 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