- Provides day to day supervision of the staff and work activities. This includes measuring daily KPI's and monitoring staff daily productivity to ensure peak performance through quantitative and qualitative measurements.
- Coordinates the collection and analysis of the team's productivity outcomes measures, quality, efficiency and comparison to service level agreements with field leaders and national databases.
- Leads the selection, training and motivation of employees; makes effective decisions regarding hiring, terminations, discipline and changes in employment status. Conducts regular performance reviews for assigned personnel. Ensures a smooth and productive onboarding for new employees. Responsible for the preparation and planning of team meetings.
- Educates employees, providers, patient care coordinators and field leaders on financial clearance processes and payer operations (and in the future price estimations).
- Stays apprised of legislative efforts related to insured and uninsured patients, educating others and recommending organizational changes to programs as a result.
- Frequently interprets the regulations and specific requirements of various third-party payers and takes the appropriate actions to ensure compliance in order to minimize bad debt and facilitates the collection of the accounts receivable. Keeps staff abreast of any changes in policies and procedures by holding training sessions/modules and maintaining procedure manuals.
- Keep up-to-date records for fee schedules and group versus provider billing in repository.
- Works with site leaders both in person and virtually to improve the operational flow of financial clearance.
- Makes sound decisions and works closely with staff when developing and implementing operating procedures as they relate to the area.
- Provides training to the clinics ensuring a clear understanding of the necessary procedures as they relate to financial clearance efforts.
- Acts as liaison between field staff and revenue cycle departments to ensure that all inquiries are addressed and work directly with field leadership for all insurance related matters (verification, authorizations, claims processing, etc.)
- Regularly monitors and revises workflow to ensure pre-receivable issues are addressed with staff and affected departments. Evaluates the work, volume, complexity and its effectiveness to ensure the integrity of the information gathered, as it is disseminated throughout all the computer systems.
- Maintains knowledge of current computer systems (i.e. POS, DM, AX and Remedy).
- Participates in the development and maintenance of department standards of practice and in the quality assurance program. Assists in formulating programs to improve operations and staffing needs ensuring compliance with JCAHO standards.
- Works with team on managing the pending clinic report of claims to assure missing documentation issues are addressed and resolved.
- Job description is not intended to include an inclusive list of responsibilities. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.