Supervisor, Member and Provider Services - Peak Health

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

Supervises and coordinates activities and employees related to all Enterprise Customer Service and processing including: billing, self-pay collections, customer service, and financial counseling of patients within West Virginia Medicine Hospitals, and University Medical labs to ensure the financial viability of the clinical and business enterprise

Minimum Qualifications

Education, Certification, and/or Licensure:

1. High school diploma or equivalent.

Experience:

1. Two (2) years of experience working in a customer service environment.

Preferred Qualifications

Education, Certification, and/or Licensure:

1. Bachelor's degree

2. Specialized courses or seminars over and above high school that are directly related to collections, medical field, hospital business office setting and/or business management

Experience:

1. Two (2) years' experience in a healthcare setting

2. Two (2) years' experience in the direct supervision of associates

Core Duties and Responsibilities

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Maintain appropriate internal control safeguards over accounts receivable records and collection of cash.

2. Establish and implement controls for appropriate submission, billing and payment cycles to ensure integrity of accounts receivable and patient information as well as supervising and controlling cash collected directly from patients.

3. Negotiate special discount arrangements, using sound financial practices, within the guidelines of State and Federal regulations.

4. Assures department compliance relating to the extension of credit, billing, and allowable follow-up.

5. Monitors daily operations to help ensure adherence to documented administrative and departmental policies and procedures.

6. Coordinates billing operations (including late charge issues, charge issues, coding issues) with other departments and/or outside referral sources/agencies/facilities to ensure continuity of care timely communication and accurate revenue cycle operations.

7. Identifies on-going continuing education needs of existing employees as well as new employees.

8. Complete annual reviews as well as 90 day review.

9. Keeps staff informed of process, policy and other changes through presentation at regular staff meetings, face to face communication and email correspondence.

10. Provides coaching and counseling to staff based upon performance management principals.

11. Efficiently and assertively coordinates resolution of problems with other departments as monitored by Manager or Director.

12. Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability, and efficiency.

13. Handles patient/family or staff complaints, investigates complaints, and makes recommendations of appropriate resolution.

14. Works with Manager or Director to develop and attain quarterly objectives.

15. Maintains confidentiality according to policy when interacting with patients, physicians, families, coworkers and the public regarding demographic/clinical/financial information.

16. Demonstrates flexibility to meet the needs of the department or hospital in regard to changes in work volume, planned change, scheduling changes, and emergency call backs (i.e. weather or disaster).

17. Maintains current knowledge of major payor payment provisions.

18. Displays and understanding of third-party payor regulations related to managed care, denials, and reimbursement issues.

19. Able to inform patients of hospital and clinic billing practices/policies and their rights and responsibilities regarding payments.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in performing duties throughout the work shift.

2. Must be able to read and write legibly in English.

3. Visual acuity must be within normal range.

4. Must be able to communicate effectively.

5. Must be able to exert in excess of 50 lbs. of force occasionally, and/or up to 25 pounds of force frequently, and/or up to 10 pounds for force constantly to move objects.

6. Must have manual dexterity to operate keyboards, fax machines, telephones, and other business equipment.

Working Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Exposed to high stress and constant interruptions.

2. Normal business office surroundings.

Skills and Abilities

1. Excellent oral and written communication skills.

2. Knowledge of business math preferred.

3. Knowledge of medical terminology preferred.

4. Knowledge of third party payors preferred.

5. Knowledge of collection procedures preferred.

6. Knowledge of ICS-9 and CPT coding preferred.

7. Excellent customer service and telephone etiquette.

8. Ability to use tact and diplomacy in dealing with others.

9. Demonstrated customer service relations.

10. Demonstrated proficiency on information system as it relates to set up of collection parameters, statement cycle, and patient follow up according to industry standards.

11. Analytical skills necessary for problem solving, motivating associates, and ensuring the development and utilization of monitoring statistics.

12. Knowledge of Fair Debt Collection Act.

Additional Job Description

Scheduled Weekly Hours: 40

Shift:

Exempt/Non-Exempt: United States of America (Exempt)

Company: PHH Peak Health Holdings

Cost Center: 2902 PHH Claims Operations