Payor Clearance Supervisor

Job Description:

Payor Clearance Supervisor (250002X2)

Under the leadership of the Manager Financial Clearance, the Supervisor Financial Clearance will be responsible for successfully supervising the administrative operations of Financial Clearance within the Revenue Cycle Department. Will be responsible for team oversight, business and financial management, human resource management, supervision, and coordination of the Financial Clearance unit within Revenue Cycle. Emphasis is placed on customer services, patient satisfaction, staff development and fiscal goals.

Responsible for assisting and supervising the financial aspects of the department and the quality assurance activities. Works with medical, nursing and accounting staff to ensure optimal outcomes.

• Minimum Education
  • Associate's Degree (Required)
  • Bachelor's Degree (Preferred)
• Minimum Work Experience
  • 5 years progressively responsible experience in healthcare revenue cycle operations for a large, complex health care environment, including experience in an academic medical center. (Required)
  • 2 years direct supervisory experience. (Required)
• Required Skills/Knowledge
  • Superior customer service skills and professional etiquette.
  • Expert knowledge of Medicare and third-party payer reimbursement preferred.
  • Intensive knowledge in managed care requirements as they relate to hospital reimbursement.
  • Strong written and oral communication skills.
  • Attention to detail and ability to multi-task in complex situations.
  • Demonstrated leadership, financial, and management skills.
  • Demonstrated ability to solve problems independently or as part of a team.
  • Knowledge of and compliance with confidentiality guidelines and CNMC policies and procedures.
  • Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers.
  • Knowledge of and compliance with regulatory guidelines, such as JCAHO guidelines, HIPAA, EMTALA.
  • Experience with IT systems related to patient access, patient accounting.
  • Experience in department budget and interpersonal communication preferred.
  • Bilingual a plus.

• Ensures that patient experience and service standards are met. Works with manager to gather and monitor departmental and program specific productivity and quality of service statistics.
• Monitors the accuracy of demographic and insurance information obtained by staff for patient registrations and authorizations and communicates any concerns to manager.
• Works with team to ensure accurate and timely claims submission.
• Investigates errors, suggests changes and/or implements solutions to encountered problems. Escalates issues to manager when appropriate.
• Keeps abreast of insurance, referral, and billing requirements. Requests system enhancements as needed to facilitate accurate registration and prior authorization and to support financially clearing a patient for services.
• Supports process improvement projects across the department.

• Supervise daily functions and activities of the Financial Clearance Unit.
• Work with manager on staffing plans that effectively manage patient/account workload while adhering to departmental budgetary guidelines.
• Monitors and drives productivity to optimize staff utilization and efficiency.
• Utilizes strong problem-solving skills to provide resolution to departmental challenges, i.e. staff performance, morale, customer complaints, backlogs in work, training deficiencies, etc.
• Effectively communicates expectations of staff roles and responsibilities, performance targets, and progress towards goals.
• Promotes staff satisfaction through understanding, clarifying mutual expectations, coaching, development, and regular communication and feedback.
• Coordinates and facilitates the development and delivery of training to staff. Implements and manages cross training to ensure adequate daily staffing coverage.
• Encourages staff to effectively prioritize, manage time, make good decisions, conduct proactive follow-up and document clearly.
• Assists staff with prioritization and time management when appropriate.
• Completes performance appraisals in compliance with organizational protocols and expectations.