Supervisor, Pre-Service

Mercy Medical Center

This job is responsible for assisting patients by communicating with insurance payors, via various methods (i.e. telephone, fax, internet) to determine eligible benefits (Full coverage, medical policy determination) and acquiring Pre-certifications when deemed necessary by the insurance payor. Additionally, responsible for communicating the liability to the patient after ensuring the Pre-Service process has been completed in advance of the patient's arrival for scheduled service(s). In addition, provide oversite of the Pre-Service program (Medical Application, Price Estimate, and Financial Clearance with patients). 
Job Duties/Essential Functions
Leadership Competencies
  • Formulates a future course that reflects departmental needs and is aligned with Mercy's vision. Translates the course into team goals and objectives, sets priorities, and directs the efforts of staff towards accomplishing them.
  • Recognizes and acts on opportunities for growth and improvement to advance Mercy's goals.
  • Inspires staff enthusiasm for and generates commitment to departmental and organizational goals.
Standards and Accountability
  • Holds team and self responsible for maintaining the highest possible performance standards and meeting agreed upon commitments.
  • Sets and maintains high standards for service to patients, physicians, colleagues, and other Mercy departments. Incorporates needs and concerns of diverse constituencies into decision making.
Planning and Decision Making
  • Analyzes problems systematically and logically and is resourceful when developing and implementing solutions.
  • Applies key financial concepts and analysis to decision making. Understands drivers of financial performance and takes these into account when developing strategies and making decisions.
  • Develops and implements work plans with actionable components and measurable outcomes. Proactively monitors key performance indicators and makes real-time adjustments to ensure that progress stays on track.
  • Regularly reassesses priorities and competing demands and adjusts allocation of own and staff time and resources to increase efficiency and effectiveness.
  • Articulates logical and well-founded arguments that support conclusions. Matches communication style to the message and audience. Actively solicits opinions from others. Routinely provides others with the information they need to do their jobs.
  • Routinely shares suggestions, advice, and insights on progress toward goals. Provides performance feedback that is constructive and actionable, and that highlights successes as well as areas for growth based on objective metrics.
Developing People
  • Selects and attracts outstanding staff from diverse backgrounds. Identifies and fills gaps in team skills and knowledge.
  • Defines development objectives for self and staff that support performance goals and progress toward future skill development. Assists staff in developing their own careers by encouraging them to articulate their career goals, offering challenging growth opportunities, and providing necessary coaching and training.
Managing Relationships
  • Builds and maintains long-term relationships with others based on mutual respect and trust. Fosters cooperation and collaborative decision-making among staff with diverse backgrounds and interests. When conflict arises, works effectively towards solutions and compromises that take the needs of all parties into account.
  • Provides regular updates on goal progress and works with own manager to minimize risks and resolve problems.
Job Duties
  • Identifies future needs, new technologies and products for applicability to the department and makes recommendations as appropriate.
  • Prepares, validates and completes all steps necessary to clear new cases for pre-scheduled services. This includes, but is not limited to validating and gathering insurance and demographic information.
  • Interacts with insurance companies via website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication. 
  • Gathers information to verify benefits and benefits eligibility by utilizing the EPIC system.
  • Completes and/or obtains all necessary authorizations for the service(s) to be performed. Works with the clinical providers, on-site case management team, as well as, team members, LPN/RN or Nurse Auditor in the Prior Authorization or CDI department. 
  • Performs Pre-Service collection estimation functions and communicates patient liability with the patient. 
  • Provides point of service information and logistics to ensure an exceptional patient experience.
  • Prepares monthly statistical reports.
  • Monitors productivity. 
  • Provide coaching for team members as needed. 
  • Other related duties as required. 
  • Follows Mercy's safety guidelines, carries out job- specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Knowledge, Skills and Abilities
  • Excellent strategic skills and overall business judgement; the ability to visualize and implement strategies required to be successful in accounts receivable management and translate this vision into a meaningful specific plan that includes performance improvement in the billing process, is compliant with HIPAA regulation and maximizes payment accuracy. 
  • A professional demeanor and communication style that fosters credibility with staff, senior management, physicians, department heads, community at large and customers of MMC.
  • Assumes responsibility for revenue cycle management. Is key leader in developing processes with hospital department heads to maximize and enhance revenue/reimbursement for services provided. Provides leadership in billing to improve transactional accuracy.
  • A management style that enhances and promotes the ability to operate in an entrepreneurial, fast moving environment and the ability to function as part of a high-level management team where the requirements are to produce results and be responsive to MMC customers.
  • The ability to create, mold and build a successful accounts receivable management program and not just maintain it.
  • Development and maintenance of reports and statistically information on a timely monthly basis.
  • Promote a high degree of interpersonal astuteness, personal integrity, compassion and the ability to gain trust of Medical Center department heads; business services staff, physicians, senior management and the Senior Vice President of Finance.
  • Exhibits good judgment, setting goals and meeting deadlines.
  • Handles confidential information with discretion and diplomacy.
  • Commitment to life-long learning, e.g., willingness to learn/upgrade skills related to duties.
  • Flexibility and dependability, works well with a wide variety of individuals and leadership styles.
  • Ability to work with minimal to no supervision.
Professional Experience
  • 3 year related experience in hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job. 
  • Required: High school diploma or equivalent.
Licensure, Certification, Registration
  • CRCR certification required, or must obtain within 6 months of hire.

Location: Mercy Medical Center - Cedar Rapids · Patient Financial Services
Schedule: Full Time, Day, 8:00-4:30

Job ID: 82054

Posted 21 days ago

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