University of Rochester Operations Supervisor, Inpatient in Rochester, New York
Full Time 40 hours Grade 010 Patient Financial Services
8 AM-4:30 PM
Provide supervisory and technical support to an Inpatient Patient Accounts team. Oversees daily billing activities and maintains control over billing and follow-up procedures for the team. Ensure that all billing and payments are processed per payer regulations and contracts. Prepare and maintain daily, weekly and monthly quality indicators for the team members, identifying goals and areas that require attention and follow-up. Serve as a liaison between the department and ISD to ensure billing processes, programs and system generated reports are maintained. Assist the Senior Operations Supervisor with planning and problem solving, goals and objectives for this area. Assist the Senior Operations Supervisor by serving as a liaison between the department and other hospital departments in areas of customer service and satisfaction. Recognize and support the Strong commitment to service excellence.
Under general direction and with latitude for independent judgment:
Provide overall supervisory and technical support and direction to the billing team. Provide and train staff to understand and adhere to contract language by payer for appropriate reimbursement to the hospital, and to ensure the accuracy of account reconciliation. In addition, the Operations Supervisor monitors compliance with timely filing requirements and takes corrective action if the guidelines are not followed.
- With support of the Senior Operations Supervisor, administers and coordinates hospital and departmental procedures relative to charges, billing, reimbursement and accounting functions
- Maintain knowledge of all current third party coverage, federal and state billing, reimbursement and compliance regulations and procedures
- Serve as a focal point for answering questions and solving problems for difficult and unusual accounts, assist in problem identification and resolution
- Review, compile, approve, and submit patient refunds and complete balance transfers
- Ensure that requests for information from patients and external contracting agencies are responded to timely
Prepare inpatient team operational reports and special reports as needed to identify key indicators for A/R activities using specific criteria measuring quality, quantity and timeliness of tasks performed. Prepare and review with Inpatient Accounts Reps and billers the weekly and monthly quality indicators of A/R activity in the billing area. Initiate corrective action or recommend solutions as appropriate. Prepare specific reports developed with payers in identifying accounts requiring provider intervention.
- Resolve Holds and Edits to ensure timely submission of claims to payers
- Monitor and ensure that worklists are completed in a timely manner
- Monitor cash flow, receivables, Hold Bills, Claim Edits, aging report
- Monitor payment and denial worklists
- Monitor quality by examining a sample of visits worked by each employee during the preceding month (check account notes, check appropriate adjustments, etc)
- Attend monthly team meetings with the Senior Operations Supervisor and appropriate payer representatives
- Run, distribute and ensure accounts on reports are resolved properly (e.g. write off reports, timely filing reports, Medicaid credits, Medicare Credits, Unbilled reports)
With the support of the Senior Operations Supervisor, develop audit procedures within the billing area to ensure payments from all third-party payers are based on rates identified on negotiated contracts.
- Ensure timely processing of secondary credit balances for government plans
- Review A/R reports generated within the billing systems to ensure accuracy and reconciliation
- Coordinate and provide support for all internal and external billing audits, reviews or projects
Along with the Senior Operations Supervisor develop goals, objectives and operating policies and procedures for the billing team. Develop cross training programs within the specific billing area for inpatient billing. Add policies and procedures to the Patient Accounts shared drive.
- Ensure a positive working environment through suggestions on team building to promote heightened team morale.
- Provide training, coaching and reinforce billing and customer service skills to team members to ensure exceptional service
- Empower team members by providing the appropriate level of decision making
- Recognize and reward team members for their contribution to the department
- Seek feedback from other departments to improve processes and level of service within the department
- Communicate with other SMH departments re: problem visits.(UM, FCs, PSR’s)
Complete additional supervisory activities:
- Complete performance evaluations for designated staff; review with Senior Operations Supervisor
- Screen, review, interview and make recommendations for new hires
- Handle time reporting requirements in accordance with state and federal regulations.
- Address personnel disciplinary issues
Act as authority in the absence of the Senior Operations Supervisor, exercising tact and good judgment.
- Attend meetings and seminars in the absence of the Senior Operations Supervisor when appropriate
- Provide coverage for other teams when their Operational Supervisors are absent.
Other duties as assigned
- Attend continuing education seminars offered by local payers, as well as by Medicaid and Medicare
- Represent the department on various internal and external committees
- Complete the mandatory leadership classes offered by the Hospital
- Attend other internal training classes as needed (Microsoft Excel training)
Participate in department/team staff meetings, educational classes and training
- Attend monthly department and team staff meetings
- Stay current on HIPAA guidelines through education and reading monthly emails.
- Participate in educational training such as Strong Commitment ICare and annual In Service
- Join Patient Accounts committees such as planning Patient Accounts events or addressing employee issues
- Cross Train on team processes to enable assistance and fill in as needed
Associate’s Degree in Business, Health Care Administration or related discipline and 3-5 years of relevant health care experience or an equivalent combination with 1 year of demonstrated leadership experience. Working knowledge of Microsoft Word and Excel and a general knowledge of researching information via using the web.
EOE Minorities/Females/Protected Veterans/Disabled
Job Title: Operations Supervisor, Inpatient
Location: Strong Memorial Hospital
Job ID: 207516
Full/Part Time: Full-Time