Insurance Verification Representative Supervisor

Luminis Health Clinical Enterprises

Title: Insurance Verification Representative Supervisor

Department: Patient Access and Support Services

Reports To: Sr. Director

FLSA Status: Non - Exempt

Position Objective

The Supervisor is responsible for assisting with the oversight of the Insurance Verification team within the Patient Access and Support Service department. The position ensures that proper documentation has been collected to effectively verify insurance benefits for ambulatory services. The position ensures that proper referrals and/or authorizations are obtained prior to the services being rendered and communicated to the necessary departments. The position will oversee auditing of work, to include Work queues for efficient and effective workflows. There is a focus on eligibility, verification, referral management, authorization management and process improvement. Promote best practices in the outpatient areas for insurance verification and authorizations to support the financial assistance of patient satisfaction and revenue enhancement. The Supervisor provides leadership support and directions to staff to ensure excellent customer service to internal and external customers and the efficient process flow to service delivery areas.

Essential Job Duties

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

• Ensures denials related to authorization issues are minimized and that the root cause of authorization denials is known and communicated to relevant department leadership.
• Mentors and develops the PASS team members. Leads by example, maintains a professional demeanor, provides clear direction and goal setting, manages by metrics, and ensures full accountability of self and team members.
• Represents the PASS department in leadership meetings to provide subject matter expertise in support of various strategic initiatives, IT system development initiatives, and other related opportunities.
• Manage pre-registration and insurance verification trends by monitoring work queues and staff performance.
• Performs routine audits to ensure compliance with Luminis Health and PASS policies and procedures and manages corrective actions in timely and in compliance
• Ensure staff complete work with a sense of accountability and ownership, as relates to their work area assignments by closely monitoring department metrics related to productivity and quality
• Conduct daily rounding, regular one-on-one meetings with all direct reports, and regular unit meetings to identify and resolve any issues
• Serves as liaison to core services for financial clearance, training, quality assurance, analytics and performance improvement
• Evaluates staff performance in accordance with the performance appraisal process
• Will be required to perform tasks of the insurance verification team when needed.
  
  

Educational/Experience Requirements

• Associate degree in Accounting, Finance, Business Administration or Healthcare, or related field- Bachelor’s Degree Preferred.
• 4-5 years registration/insurance verification and scheduling experience in EPIC, or other EHR systems within a hospital or medical office environment
• Knowledge of registration, verification, pre-certification, and scheduling procedures.
• Minimum of 1-2 years supervisory experience
• Excellent verbal and written communication skills
• Proficient in Microsoft Office and Outlook
  
  

License/Certifications

Needs to have one of the certifications below or obtain within the initial 6 months of employment if satisfies the educational/experience requirements.

• CRCE - Certified Revenue Cycle Executive
• CRCP- Certified Revenue Cycle Professional
• CRCS- Certified Revenue Cycle Specialist
• CHAM – Certified Healthcare Access Manager
• CHAA- Certified Healthcare Access Associate
• CHFP- Certified Healthcare Financial Professional
• CRCR- Certified Revenue Cycle Representative
  
  

Working Conditions, Equipment, Physical Demands

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands -

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.