Job Description

Company :

Allegheny Health Network

GENERAL OVERVIEW:

Provides direct supervision of staff within the Pre-Service Center. Assists in the management of daily operational processes.

ESSENTIAL RESPONSIBILITIES:

• Supervises staff, evaluates work and current state results, monitors staff time and recommends and implements corrective actions. Independently suggests new approaches for performance enhancement and improved productivity. Identifies, quantifies and monitors account detail or workflow processes for barriers. Makes process improvements or initiates courses of action for problem resolution. (20%)
• Uses problem solving skills and planning abilities to diagnose and solve root process, payer and system issues impacting revenue cycle objectives. Addresses team barriers, process flow or productivity issues. Completes employee performance evaluations, monitors attendance and provides disciplinary action as necessary. (20%)
• Organizes, delegates, monitors and measures special projects to ensure they are completed timely and accurately. Provides formal feedback on project results to management. (20%)
• Independently leads initiatives as assigned by management, coordinating task teams or other forums to deliver results as identified and/or determined by leadership. Provides formal updates and closure. (15%)
• Performs scheduling and preregistration duties including patient demographic validation, insurance benefit verification and coordination of benefits order. Excels in all areas of pre-service including scheduling, preregistration/registration, financial clearance and insurance verification, and check-in and financial collections. Trains and leads team members. (15%)
• Delivers a positive patient experience in all encounters. Performs any written or verbal communication necessary to exchange information with designated contacts promoting effective working relationships. Resolves patient issues in a concise and informative manner. (10%)
• Adheres to AHN organizational policies and procedures for relevant location and job scope.
• Performs other duties as assigned or required

QUALIFICATIONS:

Minimum

• BA/BS degree or equivalent work experience in a multi-physician medical practice or facility billing/business office specifically related to revenue cycle management, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
• 3-5 years' experience in a multi-physician medical practice or facility billing/business office specifically related to revenue cycle management (including staff supervision).
• Experience operating PC and using software applications.

Preferred

• Call Center experience.

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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