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Revenue Cycle Supervisor Central Insurance Verification

Remote · Nigeria Full-time

Job Title: Revenue Cycle Supervisor- CIV Department: Revenue Cycle Management Reports To: Revenue Cycle Manager FLSA Status: Exempt Summary: The Revenue Cycle Supervisor for Central Insurance Verification (CIV) will supervise insurance verification and prior authorizations patient billing processes and staff and for 165+ outpatient physical therapy facilities across 17 states. Your job duties include using reports and data to supervise a team of approximately 18 (local, remote and offshore) staff. This role will be responsible for monitoring KPIs and productivity at a department and at an individual level. This position will report directly to the Manager of RCM. Revenue Cycle Supervisor (CIV) areas of responsibility-include obtaining appropriate authorizations and providing benefits for all new evaluations scheduled and/or insurance changes. Essential Duties and Responsibilities:

  • The Revenue Cycle Supervisor is responsible for KPI and metric improvements in assigned areas of responsibility and holding the team accountable for meeting goals and objectives.
  • Supervises staff; participates in interviews; completes bi-weekly payroll; evaluates employee performance in collaboration with the manager; discusses performance problems with the managers and follows-up with staff as appropriate; delegates work assignments effectively.
  • Works closely with team members to ensure conformance to all regulatory guidelines pertaining to insurance eligibility, verification and prior authorization as well as all levels of regulatory compliance involving relationships among entities.
  • Maintains policies, processes and procedures in alignment with organizational goals, and collaborates with the leadership team on process improvement initiatives.
  • Ensure that such policies, processes and procedures are being followed appropriately.
  • Ensures team education, training and current workflows are well-documented and of high quality. Trains staff directly and/or assigns training to seasoned team members.
  • Performs team quality audits, coaches and mentors the team, and ensures that excellent customer service is provided along with optimum revenue capture.
  • Provides clear short- and long-term direction, guidance, and leadership to staff, managers, and executive teams in revenue cycle functions and supports the dissemination of consistent, reliable information throughout the organization.
  • Represents the organization by developing and maintaining external relationships with regulatory agencies, third party payers, auditors, professional associations, vendors, and counterparts in other organizations and monitors/influences external forces impacting receivables.
  • Serves on appropriate committees and/or project teams as assigned.
  • Performs miscellaneous job-related duties as assigned.

This list of duties is not intended to be all-inclusive and may be expanded to include other duties or responsibilities that senior management may deem necessary. Qualifications/Skills

  • Three (3) to Five (5) years of proven, progressive experience in healthcare receivables management and people management preferred.
  • Communication: Effective verbal and written skills, computer literate
  • Customer Service: Patient confidentiality, helpful, patience
  • Organizational: Detail oriented, problem-solving abilities, efficient
  • Team Skills: Accepts accountability for department performance improvement. Can provide team leadership and motivation.
  • Demonstrate ability to accurately audit data entry for authorizations and eligibility.
  • Follow appropriate internal standards, policies and procedures to provide optimal reimbursement and maximize workflow.
  • Demonstrate knowledge of carrier specific guidelines.

Minimum Job Qualifications

  • High School Diploma or GED
  • Working knowledge of billing/insurance terminology, account follow-up processes, and customer service
  • 3+ years of recent, relevant experience with call center management and/or patient accounting
  • Effective communication skills
  • Computer proficiency – including Word, Excel, and internet use
  • Must be available and have means to travel as necessary for orientation and training
  • High level of problem-solving ability and efficiency

Preferred Qualifications

  • Background in medical terminology
  • Previous work experience in a medical office setting
  • 5+ years of recent, relevant experience including leading a team

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