Supv- Central Business Office- Troy/Jackson

📁
Business (Non-Clinical)
📅
1911261 Requisition #



GENERAL SUMMARY:


The Corporate Business Office (CBO) Supervisor works closely with the respective CBO Manager.  Responsible for coordinating and leading a designated area within the CBO across a multi-facility integrated healthcare delivery system; which includes all insurance billing and self-pay associated with HFHS hospitals, outpatient clinics and employed physicians.


Responsible for oversight and support of the designated area of responsibility to provide timely billing processing and ensure accurate response to customers.  Builds and maintains strong working relationships with departments to resolve patient inquiries.


 

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Payment Application:   Supervisor is responsible for functions related to timely and accurate posting of insurance and patient payments.  This includes but is not limited to:

  • Application of cash and contractual adjustments/discounts
  • Research and follow up of misapplied or missing payments

  • Timely balancing and reconciliation of all cash posted

  • Document storage and retention.

  • Timely resolution of self-pay credit balances


Self-Pay: Supervisor is responsible for functions related to timely and accurate responses to patient inquiries.  This includes but is not limited to:

  • Coordinating timely response to patient’s inquiries regarding outstanding liabilities

  • Ensuring patients are provided options, such as payment arrangements, payment in full, financial support, etc., to resolving outstanding patient liabilities

  • Timely and accurate billing insurance information when identified through self-pay and agency inquiries.

  • Processing subpoena requests and agency legal requests, bankruptcy notices, etc.

  • Assisting with the Pricing Department processes and procedures in an effort to ensure our pricing estimates are created accurately and timely.


Service Center: Supervisor is responsible for functions related to timely and accurate responses to patient inquiries.  This includes but is not limited to:

  • Coordinating timely response to patient’s inquiries regarding outstanding liabilities

  • Ensuring patients are provided options, such as payment arrangements, payment in full, financial support, etc., to resolve outstanding patient liabilities

  • Maintains appropriate processing of high financial risk patients through established guidelines, including referral to the Patient Care Management Advocate (PCMA) when needed to ensure we maintain continuity of medical care as appropriate.

  • Timely and accurate billing insurance information when identified through Service Center inquiries.

  • Proper handling of supervisor calls as calls are escalated, resolving customer complaints/issues within a specified time frame

 

Insurance  Billing: Supervisor is responsible for office functions related to timely, accurate and compliant billing.  This includes but is not limited to:

  • Coordinating timely and accurate claims submission for adjudication
  • Coordinating and developing timely denial follow up processes and identifying solutions to prevent denials.

  • Oversee follow up to ensure all claims are resolved or responded to by the payers.
  • Monitoring and adjusting workflow processes and work queues to ensure staff are working the appropriate accounts

  • Oversees daily operational activities including scheduling and work assignments

Monitors and maintains acceptable work queue volumes ,for DNB’s, Claim edits, Denials and follow up

 

Central Authorization: Supervisor is responsible for functions related to timely procurement of referrals and authorizations and denial management related to scheduled outpatient services..  This includes but is not limited to:

  •  Performing as a central resource to proactively and continuously educate impacted staff on payor regulations/ requirements,
  • Coordinating staff work load to ensure referrals and authorizations are secured prior to patient arrival

    • Monitoring and adjusting workflow processes and work queues to ensure staff are working the appropriate accounts

    • Monitoring and maintaining acceptable work queue volumes for Referrals, DNB’s, Charge Review and Denials 

  • Facilitating communication between insurance representatives, clinicians, case management, clinical staff, central business office, community physician offices and patients as needed

  • Actively participating in educating and improving performance with personnel at the clinic site

  • Communicating with insurance payors regarding authorization issues. May be the hospital representative at external meetings which involve HFH management.

  • Ensuring that services with high risk of denial or with high charges are verified for accuracy prior to claim submission

  • Managing authorization related denied claims to ensure the highest rate of payment recovery possible

  • Acts as a central resource to manage, monitor and track data related to underpayments, denials and revenue opportunities to plan/implement performance improvement strategies






EDUCATION/EXPERIENCE REQUIRED:

  • Associate’s degree in Business Administration, Accounting, or related field preferred. 
  • Two years of experience with healthcare accounts receivable required.

  • Knowledge of best practices related to revenue cycle operations and day-to-day functionality.

  • Knowledge of CPT and diagnosis coding and Third Party billing regulations preferred.  

  • Experience at a large, complex, integrated healthcare organization preferred.

  • Experience with insurance billing, patient accounting systems and other related applications preferred.

  • Communication skills and the ability to interact effectively with staff.

  • Ability to manage, coordinates, and leads simultaneously.  Ability to estimate time frames and meet projected deadlines.  

  • Ability to work with a variety of individuals in executive, managerial and staff level positions.

  • Ability to work independently.

  • Ability to understand and lead change.

  • Goal oriented, exceptional interpersonal skills, change management and political skill.



     Overview

       Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health

       care systems, is a national leader in clinical care, research and education.  The system includes

       the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health

       insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory

       network and many other health-related entities throughout southeast Michigan, providing a

       full continuum of care.  In 2015, Henry Ford provided $299 million in uncompensated care.

       The health system also is a major economic driver in Michigan and employs more than 24,600

       employees.  Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient.  The

       health system is led by President and CEO Wright Lassiter III.  To learn more, visit HenryFord.com.

     Benefits

       Whether it's offering a new medical option, helping you make healthier lifestyle choices or

       making the employee enrollment selection experience easier, it's all about choice.  Henry

       Ford Health System has a new approach for its employee benefits program - My Choice

       Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

       dozens of options for all of our employees including compensation, benefits, work/life balance

       and learning - options that enhance your career and add value to your personal life.  As an

       employee you are provided access to Retirement Programs, an Employee Assistance Program

       (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness,                 and a whole host of other benefits and services.  Employee's classified as contingent status are not         eligible for benefits.    

      Equal Employment Opportunity/Affirmative Action Employer

        Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

        committed to the hiring, advancement and fair treatment of all individuals without regard to

        race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

        weight, marital status, family status, gender identity, sexual orientation, and genetic information,

        or any other protected status in accordance with applicable federal and state laws.

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