RCM Supervisor

Description

About Primary Health Solutions

Our Mission

We meet people where they are and partner with them on their journey towards wellness.

Our Vision

The destination for servant leaders to provide comprehensive and exceptional care.

Our Values

R – Respect

I – Innovation

S – Stewardship

E – Excellence 

Revenue Cycle Supervisor I Summary

The Revenue Cycle Supervisor (RCS) oversees revenue cycle operations in collaboration with the Director & Sr RC Manager to ensure timely and accurate reimbursement. This role is responsible for overseeing staff, reviewing system & clearinghouse issues, while working with the Payer Coordinator to resolve payer issues. The RCS handles initial patient issues and collaborates with RCM management & 3rd party billing company on revenue cycle processes. The RCS leads training efforts to ensure performance management and efficient and compliant operations per focus provided by the SRCM, & DRCM to meet PHS’s Goals

A Day in the Life

· Manage RCM staff performance, providing regular feedback & conducting one-on-one meetings.

· Identify patient reimbursement issues on claims, denials and appeals to resolve billing issues.

· Collaborate with RCM Management &Payer Enrollment coordinator to resolve provider issues, 

· Works with RCM Management & Operations to ensure accurate billing information is obtained

· Review financial hardship applications (sliding fee scale) to RCM Management for approval

· Efficiently manages patient complaints., and/or escalates to RCM management, if appropriate

· Provide Training to front desk staff, practice managers, and other staff on payer processes 

· Work with coding and quality staff for educating providers on correct coding practices.

· Work directly with payers on claims issues

· Collaborating with Sr RCM on payer contracts, for review with DRCM and Payer Coordinator

· Assist and cover RCM and payer enrollment follow up needs as needed, 

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Core Competencies

· Customer Service: Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.

· Communication: Understand and communicate effectively with others using various contexts and formats, including writing, speaking, reading, listening and interpersonal skills.

· Dependability: Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.

· Quality: Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.

· Productivity: Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, and handles information flow.

Requirements

Success Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience

· High School Diploma is required

· 5 years in Physician’s related billing

• eligibility, charges, payment, denials and appeal process

· Some hands-on Coding knowledge and/or experience required

· EMR/EFT systems experience required, (Epic, NextGen, Athena, E-Clinical Works,,)

· Proficient in all Microsoft Office applications, as well as medical office software.

· Sound knowledge of health insurance providers.

· Ability to multi-task and work in a team environment a must

· Knowledge of professional fee billing, reimbursements and third-party payer regulation and medical terminology is required.

· Associate’s degree is preferred.

· Specialty Experience a plus

· NextGen experience a plus, with NextGen certificates desirable.

· FQHC Experience a plus

· Payer Enrollment knowledge or experience a plus

Supervisory Responsibilities

Supervises Revenue Cycle personnel in various duties, such as account management, eligibility, communications with insurance providers, collections, cash posting, contract analysis, and billing.

Language Skills

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of an organization.

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Computer Skills

To perform this job successfully, an individual should have the ability to gain proficient knowledge of current practice management systems, electronic medical record, Microsoft Office 365, patient portal, phone systems, text paging, Internet, and Intranet.

Physical Demands

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 accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is occasionally exposed to fumes or airborne particles, toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate.

EEO Statement

It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information, or any other protected characteristic under applicable law.

Other Duties 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.