Supervisor, Pre-Arrival

Job Summary: The Supervisor, Pre-Arrival provides supervision and guidance for the prior authorization and pre-arrival billing and collections functions of the revenue cycle. This role is accountable for supervising the daily operations of the prior authorization and pre-arrival processes including staff supervision, issue resolution, and acting as a technical resource while consistently meeting productivity and quality metrics.

Minimum Education: High School Diploma or GED. Associate’s Degree in a healthcare related field preferred.

Licensure, Registration and/or Certification: None.

Work Experience: Minimum of 5 years of related experience.

Knowledge, Skills and Abilities: Excellent communication, telephone, customer relations and organizational skills. Ability to work and lead staff in a fast-paced environment. Working knowledge of regulatory and accrediting agency requirements. Knowledge of payer requirements for area of responsibility. Working knowledge of on-line computer systems/applications; ability to perform telephone activities concurrent with computer activities. Demonstrated and working knowledge of medical terminology. Working knowledge of basic business office equipment. Ability to organize and prioritize work in an effective and efficient manner.

Essential Functions and Responsibilities: Supervises and guides the daily operations, responsibilities, and activities of the prior authorization and pre-arrival team. Reviews daily operational reports to prioritize and distribute work to staff to guarantee timely workflow and exceptional customer service is achieved. Reviews and researches elevated issues; working with pertinent stakeholders to resolve them in a timely and efficient manner. Monitors staff compliance with applicable laws, regulations, and standards as required by government agencies, third-party payers, Joint Commission, and the health system’s policies and procedures; reporting any non-compliance issue to management for input and resolution. Assists management with the recruitment, interviewing and hiring of team members; supporting initiatives that encourage staff retention. Coordinates daily schedules to ensure proper coverage of the work unit is sustained, monitoring overtime hours and ensures the schedule compiles with the authorized budgeted hours. Assists management with the annual performance review process, offering recommendations and valuable input; conducts annual performance reviews for employees, as requested by management.

Decision Making: Independent judgment in making decisions involving non-routine problems under general supervision.

Working Relationships: Direct supervision of others. Prepares and gives performance evaluations. Works directly with patients and/or customers. Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

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