Pre-Access Regional Operations Supervisor, AdventHealth Tampa
Location Address:3100 East Fletcher Avenue Tampa, Florida 33613
Top Reasons to Work at AdventHealth Tampa
AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
"Insert Full Time/Part Time/PRN (Shift Information)
You Will Be Responsible For:
• Accountable for day-to-day functions of assigned area, ensuring all patient accounts for the region and/or division are financially cleared in a timely manner with appropriate follow up for account completion. Stays current with payor guidelines, managed care changes to authorization practices, all relevant payor portals and their third party vendors to cascade communication to respective team members timely.
• Implements, supervises and monitors region wide processes related to financial clearance including eligibility and verification of benefits, pre-authorization of services, notification of admission and pre-registration call center activities to ensure complete Financial Clearance is achieved 3 to 5 days out from date of service. Works with team to ensure appropriate expectations regarding verification, pre-authorization, and collection standards
• Serves as single point of contact for initial communication with service partners inclusive of medical group, managed care, ancillary and support departments and is the first stage of the escalation process to leadership. Escalates high-priority accounts with
missing authorization or limited benefits to appropriate clinical personnel to determine whether rescheduling is necessary.
• Audits performance and provides education to front line staff in order to maintain or exceed accuracy level standards. Provides constructive feedback that motivates the team and enhances knowledge to assist in meeting accuracy standard goals, minimize department registration errors, rejections, and avoidable denials. Specifically audits and ensures direct reports obtain authorization approval dates, CPT Codes, determine if procedure is considered cosmetic and verifies any other items used for procedures to aide in reduction of avoidable denials and write offs.
• Ensures appropriate communication is maintained with physicians, Consumer Access support staff, scheduling, third party payors, payor provider reps, managed care, contract management, patients and their guarantors to assist with optimizing appropriate financial clearance, timely access to care, appropriate billing of services, maximum revenue collection and high customer satisfaction.
• Collaborates closely with key stakeholders in Consumer Access, including direct interaction with physicians and clinic support personnel on all financial reporting matters, operational outcomes and issues to assist with developing and maintain productive working relationships.
• Runs/schedules reports and/or monitors work lists and distributes to appropriate staff ensuring representatives have work needed at all times and leadership is kept apprised of issues in performance or processes in a timely manner.
• Call center function requirements:
o Manage and drive real-time process, including on call routing, agent skilling/attributing to maximize agent utilization.
o Manages Contact Center daily productivity, projects and workload balance to ensure that key responsibilities are processed to meet and/or exceed department goals in accordance with Service Level and Organizational Level Agreements. Communicates outcomes to team and leadership in a timely manner, providing accurate statistical records and reports.
o Proficient at reading reports generated from call center tool to identify opportunity areas related to answer rate, abandonment rate and agent utilization.
• Works with Talent Acquisition for staffing needs. Oversees new hire training to successfully meet 90-day productivity standards.
• Ensures team success in meeting and exceeding stated monthly KPIs to protect financial standing of AdventHealth, by holding staff accountable for individual goals set by corporate and department leadership.
• Responsible for coordinating and setting up schedules for team members’ training and education sessions. Monitors team time and attendance according to policy, flexing as needed and reducing costs where applicable.
• Responsible for checking in with team members at a regular cadence to provide mentorship, resolve issues, and ensure performance is reviewed according to policy. Is readily available to staff and Lead in person or by phone to answer questions and resolve issues.
• Responsible for addressing progressive counseling according to policy
• Identifies problems proactively for expedited resolution. Initiates and assumes responsibility for new tasks independently as appropriate and as delegated
• Maintains skill level and knowledge by reading updates, attending training sessions and completing study materials as needed. Completes department competencies as required and ensures staff complete competencies by the due date.
• Performs other duties as assigned
What You Will Need:
KNOWLEDGE AND SKILLS REQUIRED:
• Mature judgement in dealing with patients, physicians, and insurance representatives
• Advanced understanding of insurance authorization and benefits knowledge
• Advanced understanding of hospital electronic medical report (EMR) and telephony system along with technological aptitude to master additional programs and technologies as needed
• Intermediate knowledge of Microsoft programs and familiarity with database programs
• Ability to operate general office machines such as computer, fax machine, printer, and scanner
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient fashion
• Ability to communicate professionally, both verbally and nonverbally, and utilizes effective listening and questioning techniques
• Ability to manage diverse personalities
• Ability to adapt in ever changing healthcare environment
• Ability to follow complex instructions and procedures, with a close attention to detail
• Adheres to government guidelines such as CMS, EMTALA, and HIPAA and AdventHealth corporate policies
• Exceptional customer service skills
• Advanced understanding of insurance knowledge and benefits
• Advanced understanding of hospital electronic medical report (EMR) system
• Basic medical terminology
• Must be able to read, write, and speak conversational English
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature as needed to perform duties
Knowledge and Skills Preferred:
• Intermediate medical terminology
• Bilingual – English/Spanish
Education and Experience Required:
Associates Degree or 2+ years of experience
EDUCATION AND EXPERIENCE PREFERRED:
• Lead or supervisory experience
LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:
This position has supervisory responsibilities for a team with region and/or divisional accountabilities. These responsibilities include management of day-to-day operations, as well as scheduling, staffing, coaching, and mentoring a team of people.
The Pre-Access Supervisor directs and manages staff in performing Pre-Access related activities, including ensuring patients are appropriately registered for all service lines, performing eligibility verification obtaining pre-cert and/or authorizations, making financial arrangements, requesting and receiving payments for services, performing cashiering functions, and clearing registration errors and editing pre-bill.
The Supervisor is responsible for region and/or division wide outcomes, the performance of their team and holds each staff member accountable for the performance of assigned day-to-day activities, to include ensuring effective use of computer equipment and materials within departmental budget and quality standards. Engages with staff to ensure AdventHealth is promptly and accurately helping patients with their needs. Monitors staff productivity levels, quality of output, and resolves workplace-related issues in a timely manner to promote a culture of accountability driving towards continuous performance improvement. Ensures Pre-Access functions meet or exceed key performance indicators. Provides training to team and manages team members’ schedules. Oversees efficient departmental operations. Is involved with the day-to-day operations of the team. Serves as a liaison to other revenue cycle teams within AdventHealth, as well as external constituents/stakeholders including physician practices and managed care. Participates in enterprise-wide projects, work groups, task forces, councils, and committees. This position may require occasional travel. Adheres to AdventHealth Compliance Plan and to all rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.