PASC Pre-Certification Supervisor - CPC - Mon - Fri 9:00am - 5:30pm

8 Hr Morning - Afternoon

About the Role

The Supervisor Precertification reports directly to the Manager of Precertification and is responsible for activities relating specifically to both inpatient and outpatient scheduled procedures and admissions, insurance verification, and monitoring of pre-certification related denials. This role works in conjunction with Financial Counseling, Physician Offices, Clinical Service Lines, Case Management, UR, and PFS.

Responsibilities include assisting with timekeeping, training new hires or remedial training for current employees, trending errors, updating Standard of Works as necessary, and enforcing NGHS policies, IT processes, and Patient Access Policy and Procedures.

Responsibilities

• Development of various educational tools: Paper handouts, HealthStream Courses, Physician Web Site Help Pages.
• 1-1 training or managing small groups on multiple computers for office staff.
• Assisting in timekeeping responsibilities as needed.
• Resolving Claim Edit Workqueue accounts and keeping them below the set goal amount.
• Improvement work trending for employees, denials, etc., to address barrier-related issues.
• Ensuring daily staffing plans are adequate to cover patient demands.
• Tracking and trending data to identify barriers, creating workflows to improve processes, and metrics to show improvement.
• Utilizing current knowledge regarding education trends and methodologies.
• Anticipating and resolving routine issues; providing input to enhance system functionality.
• Coordinating physician and physician office service requests and incident resolutions.
• Providing on-call support as needed.
• Visiting physician offices to promote and maintain relationships.
• Providing increased visibility and support during all downtimes, planned and unplanned.
• Assessing ongoing educational needs of staff; developing and implementing training plans to address deficiencies.
• Collaborating with leadership to optimize current systems to meet patient needs.
• Assisting with development and implementation of future hospital systems.
• Participating in special projects and performing other duties as assigned.
• Evaluating the effectiveness of education programs.
• Utilizing aggregate data, research, and trends when developing education programs.
• Actively participating in related committees and task forces.
• Providing employee feedback to the manager for performance evaluations.
• Demonstrating excellent detail management, self-motivation, and consistent, reliable customer service.

Requirements

• CPC Certification Required (AAPC or AHIMA certification accepted).
• High School Diploma (minimum educational requirement).
• Five (5) years of related pre-certification/insurance verification experience.
• Two (2) years of progressive leadership experience.

Preferred Qualifications

• Bachelor’s Degree.

Skills

• Ability to test, analyze, troubleshoot, and isolate complex problems.
• Demonstrated competency in Microsoft Office products (Word, Excel, Microsoft Project, PowerPoint).
• Excellent interpersonal, written, and oral communication skills.
• Excellent time management skills.
• Detail-oriented with the ability to multi-task.
• Understanding of Revenue Cycle and Regulatory Guidelines such as CMS, EMTALA, and HIPAA.
• Familiarity with developing educational assessment tools.
• Understanding of physician needs, practice patterns, and workflow in hospitals.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally (0-30% of time).
• Weight Carried: Up to 20 lbs, Occasionally (0-30% of time).
• Vision: Moderate, Occasionally (0-30% of time).
• Kneeling/Stooping/Bending: Occasionally (0-30% of time).
• Standing/Walking: Frequently (31-65% of time).
• Pushing/Pulling: Occasionally (0-30% of time).
• Intensity of Work: Frequently (31-65% of time).
• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving.