Eligibility Supervisor

Job Summary

The Benefits and Eligibility Supervisor will play a crucial role in ensuring the smooth operation of patient billing processes within the Revenue Cycle. Under the leadership of the Financial Eligibility Manager, this position is responsible for overseeing the verification of a client’s Financial Eligibility information, resolving any issues that arise, thereby ensuring that the billing process is efficient and accurate. The Supervisor will assist in the day-to-day operations within Benefits and Eligibility, providing training and support to ensure that all team members are equipped to manage their responsibilities effectively.

• Supervise, coach and evaluate Benefits and Eligibility Representatives, including performance reviews, productivity monitoring, and skill development.
• Oversee daily workflow assignments ensuring tasks are completed within agency turnaround standards.
• Assist in the validation of automation/scrape processes and provide assistance to resolve system errors in collaboration with the Financial Eligibility Manager, IT, Business Intelligence, and automation vendors.
• Maintain and routinely audit various reports, to include the ’48-hour/Financial Eligibility Reporting’ to ensure completeness and accuracy within targeted timelines.
• Serve as a Subject-Matter Expert and escalation point for high-priority/walk-in clients Financial Eligibility matters, including Medicaid Enrollment, to ensure timely resolution for client’s treatment appointments.
• Conduct regular audits of Eligibility work to ensure data accuracy and integrity, compliance with Payer Rules, and documentation completeness.
• Collaborate with Revenue Cycle Leadership to assist in the development of documented workflows and processes.
• Partner with the Financial Eligibility Manager to onboard and train new hires on the Benefits and Eligibility Team.
• Coordinate departmental meetings and training sessions to support continuous improvement.
• Assist in the monitoring of Benefits and Eligibility Team Productivity/Quality Assurance Metrics.
• Other duties as assigned and deemed necessary.

• Know, understand, incorporate, and demonstrates the FCS Mission, Vision, and Values in behaviors, practices and decisions.
• Work with Revenue Cycle leadership to ensure understanding of Payer contracts, application of contract terms and ensure alignment with processes.
• Monitor all Medicare and Medicaid websites, other Payer websites and newsletters regarding medical policies and changes impacting charging, compliance, coding and billing. Partner with RCM leadership to apply updates and ensure compliance and revenue optimization.
• At the direction of the Financial Eligibility Manager and Reimbursement Director, partner and assist Revenue Cycle leaders to formally assess the developmental needs of the department on a periodic basis and promote opportunities for development.
• Assist in the development and maintenance of dashboards, reports, and KPIs to monitor revenue cycle health.
• Collaborate with RCM leaders to reduce denials, enhance collections, and streamline workflows.
• Ensure work assignments are performed and supported to achieve departmental goals and outcomes.

• Associate degree in a related field required

• Five years or more experience in healthcare, preferably Behavioral Health, including two to three years of management experience.
• Experience with billing through EHR (electronic health records).
• Financial Eligibility, Insurance Verification, and/or Medicaid Enrollment experience strongly preferred.

• Knowledge of government and commercial insurance procedures, regulations and billing requirements.
• Strong analytical and organization skills required.
• Strong ability to lead and/or work as a member of various cross-functional teams.
• Must have well-developed written and oral communication skills.
• Strong understanding of quality customer service.