Supervisor Business Operations-Phys Med & Rehab Outpt Svcs

UnityPoint Health St. Lukes

Requisition ID
2020-84666
Category
Leadership - Non-Nursing
Location
US-IA-Cedar Rapids
Address
1026 A Ave NE
Affiliate
1010 UnityPoint Health CR St Lukes Hospital
City
Cedar Rapids
Department
Rehab Administration
State
IA
FTE
1.0
FLSA
Exempt
Scheduled Hours/Shift
M-F, first shift
Work Type (Portal Searching)
Full Time Benefits

Overview

Description of Position:

Provide a “snapshot” or the principal purpose or focus of the position, consisting of no more than three to five sentences.  This summary should provide enough information to differentiate the major function and activities of the position from those of other positions.

Oversees business operations for all the Therapy Plus clinics, Witwer Children’s therapy clinics, hospital outpatient therapy clinic and PMR physician clinic.  Ensures accurate and timely reception, billing, scheduling, charge and data entry, insurance pre-authorization and benefit verification, report preparation, filing and record keeping and other duties which assist with the delivery of timely and effective rehabilitation services.  Responsible for the areas of planning, organizing, budgeting, supervising, evaluating, staffing, scheduling, training and educating scheduling/financial specialists.  Responsible for financial/chart audits, divisional charge master for PMR outpatient services.  Works closely with St. Luke’s financial analyst to assure reimbursement is captured per payer contract.  Has oversight of all PMR outpatient clinic front office staff, insurance specialist, and Leads of business office services in the PMR division.

Responsibilities

Essential Functions/Responsibilities:

Essential functions are the duties and responsibilities that are essential to the position (not a task list).  Do not include if less than 5% of work time is spent on this duty.  Be specific without giving explicit instructions on how to perform the task.  Do not include duties that are to be performed in the future.  Duties should be action oriented and avoid vague or general statements. 

% of Time

(annually)

   Business Services

·         Oversees scheduling/receiving/greeting of patients. Ensures welcoming environment for patients served. Effectively manages positive relationships with referral sources and other members of the team.

·         Oversees billing/insurance/counseling:  insurance verification, pre-authorizations, benefits checking of all incoming patients, and patient notification of insurance coverage for therapy, which may include coordination with Price-line and counseling patient on process for prompt pay and financial assistance applications.  Stays current on changes with insurance plans (HealthPartners, Medicaid). Updates schedulers and therapists on changes.

·         Oversees accurate billing/collection/denials.  Oversees the proper and accurate posting of payments and adjustments to patient accounts. Resolves insurance denials and patient concerns regarding billing. 

·         Problem solves, analyzes and collaborates with patient, therapist, providers, case managers, Central Billing Office, Revenue Cycle department, and insurance companies to identify and resolve billing and denial issues, including sending appeals and trouble-shooting and correcting claim or account errors.

·         Responsible for the management of medical records, ensures proper storage, retrieval and release of medical records.

·         Oversees insurance specialist and business office front line staff to assure Monitors are in place and accounts are complete on multiple work queues in EPIC, including referrals and denials.

 

·         Identifies denial and billing processes that need improvement to maximize efficiency and ensure proper payment within the department.

·         Responsible for processing and reconciling of month end reports.  Oversees data collection and is responsible for summaries of statistics and data.

·         Oversees the maintenance of scheduler orientation manuals and insurance resource files

·         Oversees outcome collection and data entry

·         Maintains the PMR outpatient clinic area’s charge master and assures timely updates.

·         Incorporates latest reimbursement guidelines into billing process.

·         Serves as liaison between PMR division, St. Luke’s finance department and UnityPoint CBO and charge master personnel.

·         Conducts/oversees routine billing audits with collaboration from appropriate departments to validate accuracy and compliance.

50 %

 Resource Management

·         Assists with management of therapy business operations.  This includes measurement of the department's effectiveness using quality metrics, patient satisfaction ratings and financial data.

·         Investigates variances and initiates corrective action or justifies non-adherence to quality, financial and patient satisfaction outcome goals.

·         Maintains appropriate staffing levels to meet business service needs.

·         Assists with process improvements for supply management, approves supply orders

Staffing and Staff Development

·         Oversees staffing of business office functions in accordance with FTE budgets for PMR outpatient clinics.

·         Supports business office Leads and therapy managers to screen applications, conducts phone interviews, sets up and completes in person interviews for scheduling and finance specialists. 

·         Works closely with Leads to ensure all orientation and on-boarding of scheduling and finance specialists occurs effectively.

·         Completes and delivers performance assessments for scheduling and finance specialists and office Leads.

·         Works with PMR business office Leads to assure daily staffing needs are being met, and to determine schedule changes and staff reallocation.  Collaborates with all relevant therapy areas to determine schedules and staff reallocation.  Anticipates staffing and scheduling needs, overtime usage and vacation replacement needs.

·         Ensures adequate competence of scheduling/financial specialist staff in assigned areas.

·         Assists with in-service, on-the-job training and continuing education programming to meet identified staff development needs.

·         Assists with education programming for staff in assigned area.

·         Oversees office lead scheduling and financial specialists for PMR division who is responsible for adequate staffing, orientation, competency training, and denials, and assisting supervisor with projects and performance improvement.

·         Oversees and ensures the timely processing of department payroll in all the PMR outpatient areas.

30%

 Program Planning and Development

·         Collaborates with Physical Medicine and Rehabilitation management, physicians and others to facilitate planning, implementation and evaluation of strategic plan and other initiatives including recommending annual goals and objectives for assigned area.

·         Assists with planning and implementation of written goals and objectives.

·         Effectively communicates hospital and division mission, vision and strategic framework.

·         Facilitates the organization and coordination of the delivery of services and care provided through assigned area.

·         Assists with development of annual F.T.E., operations, and capital expense budgets for assigned area.

·         Reviews referral and monthly data for the division to analyze trends and advise on potential marketing visits

10 %

Basic UPH Performance Criteria         

·         Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

·         Demonstrates ability to meet business needs of department with regular, reliable attendance.

·         Employee maintains current licenses and/or certifications required for the position.

 

·         Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.

·         Completes all annual education and competency requirements within the calendar year.

·         Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse.  Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff.  Takes appropriate action on concerns reported by department staff related to compliance.

10%

Disclaimer: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that required of the employee.  Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Demonstration of UPH Values and Standards of Behaviors

Consistently demonstrates UnityPoint Health’s values in the performance of job duties and responsibilities

Foster Unity:

·         Leverage the skills and abilities of each person to enable great teams.

·         Collaborate across departments, facilities, business units and regions.

·         Seek to understand and are open to diverse thoughts and perspectives.

Own The Moment: 

 

·         Connect with each person treating them with courtesy, compassion, empathy and respect

·         Enthusiastically engage in our work.

·         Accountable for our individual actions and our team performance.

·         Responsible for solving problems regardless of the origin.

Champion Excellence:

·         Commit to the best outcomes and highest quality.

·         Have a relentless focus on exceeding expectations.

·         Believe in sharing our results, learning from our mistakes and celebrating our successes.

Seize Opportunities:

·         Embrace and promote innovation and transformation.

·         Create partnerships that improve care delivery in our communities.

·         Have the courage to challenge the status quo.

Qualifications

 

Minimum Requirements

Identify items that are minimally required to perform the essential functions of this position.

Preferred or Specialized

Not required to perform the essential functions of the position.

Education:

 

 

 

Bachelor’s degree in Administration, Business or Bachelor’s degree in a medical field required, or an equivalent combination of education and experience.

 

 

Experience:

 

 

 

 

·         Five years business office experience

·         Experience in Microsoft Word, Excel, Power Point and Outlook

 

·         Experience with medical insurance processing

·         Extensive knowledge of Medicare, Medicaid, ICD-10 CCI edits, local payer coding and billing guidelines and how they pertain to physical, occupational, or speech therapy

·         Prior health care experience

·         Supervisory experience

License(s)/Certification(s):

 

 

 

 

 

Knowledge/Skills/Abilities:

 

 

 

 

·         Requires extensive knowledge of commercial and worker’s compensation insurance

·         Understands health care reform related to assigned area

·         High organizational skills

·         Ability to multi-task

·         High attention to detail

·         Possess a high level of integrity and initiative and communicates effectively

·         Ability to lead, direct and manage other and delegate effectively

·         Must demonstrate an aptitude and interest in health care billing functions and reimbursement.

·         Applies well-developed human relation skills in individual and group interactions

·         Writes, reads, comprehends and speaks fluent English

 

 

Other:

 

 

 

·         Works well with all customers and co-workers at all levels of the organization

·         Demonstrates a cooperative, courteous and dependable work performance

·         Maintain confidentiality at all times

·         Adhere to the UnityPoint Health FOCUS values and standards of behaviors

 

 

Job ID: 72462

Posted 15 days ago

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