Supervisor, Financial Counseling, Surgery and UM

Position Summary : The primary role is to supervise the Utilization Management, Surgery Registration, and Financial Counselors activities to insure a payor source is identified prior to or within 24 hours of an admission.

The role includes ensuring accuracy of financial information and clinical information is communicated to the appropriate payors to insure all services provided are reimbursed.

The Supervisor provides the necessary support and leadership to achieve departmental goals and objectives. The Supervisor oversees the financial impact of daily admissions and coordinates any clinical payer concerns with the Utilization management department.

Demonstrates overall improved Revenue Cycle performance within the financial counseling and Utilization management areas.

Continues to support Patient Access performance.

Supervisory / Management Responsibilities : This position is responsible for personnel recruitment and development and initiating disciplinary action to staff.

Communications Required : The ability to interpret and explain clinical reimbursement issues to staff and management.

Ability to present ideas and information in a clear concise, manner both in written and verbal format. Ability to adapt communication style to different audiences.

Ability to demonstrate effective teambuilding exercise. Ability to communicate effectively and timely regarding changes.

Decision-Making Required : Facilitates and or makes timely and effective decisions and resolves identified problems.

Problem-Solving Required : Ability to demonstrate root cause analysis. Understands workflows and impact in Epic with ADT and Cadence applications.

Ability to prioritize effectively and efficiently. Applies critical thinking to make decisions and follow through on complex patient situations.

Financial Responsibilities : Responsible for accessing high risk accounts at financial risk and establishing protocols to avoid delays in authorization and concurrent review processes.

Ability to review denial trends and assess problem payers effectively.

Knowledge, Skills, and Abilities :

• In-depth knowledge of the current insurance world, preferably as it relates to Hospital Admissions, including extensive understanding of MediCal, California Children’s Services, Managed Care, MediCal Managed Care and other payor classifications...
• Ability to work independently, Ability to process accurate information within defined time frames.
• A strong self- starter with the ability to prioritize in a fast pasted environment
• Excellent Medical terminology.

Technical Knowledge : Microsoft Office Suite (Word, Excel),Visio, EPIC or other electronic Medical System preferred.

Minimum Education : Associates Degree in business, health care administration or other related field or equivalent combination of education and related work experience.

Minimum Experience : Five years in a hospital, or clinical setting, preferably Utilization Management, Financial Counseling or related fields.

Physical Requirements : Sit : Up to 8 hours / dayStand / Walk : 3-6 hoursBend / Stoop : Up to 3 hoursReach : Up to 3 hoursRep Use of UE / Grasp : Up to 8 hrsLift / Push / Pull : 15 lbsThis job requires the ability to hear alarms clients and / or instruction.

The ability to see accurately from 20 inches to 20-ft. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of this position.

PI254174283