*Supervisor- Central Authorization/Full Time/Hybrd - Michigan Residents

The Corporate Business Office (CBO) Supervisor works closely with the respective CBO Manager. Responsible for coordinating and leading a designated area within the CBO across a multi-facility integrated healthcare delivery system; which includes all insurance billing and self-pay associated with HFHS hospitals, outpatient clinics and employed physicians. Responsible for oversight and support of the designated area of responsibility to provide timely billing processing and ensure accurate response to customers. Builds and maintains strong working relationships with departments to resolve patient inquiries.

Central Authorization:

Supervisor is responsible for functions related to timely procurement of referrals and authorizations and denial management related to scheduled outpatient services.. This includes but is not limited to:

* Performing as a central resource to proactively and continuously educate impacted staff on payor regulations/ requirements,

* Coordinating staff work load to ensure referrals and authorizations are secured prior to patient arrival. Monitoring and adjusting workflow processes and work queues to ensure staff are working the appropriate accounts . Monitoring and maintaining acceptable work queue volumes for Referrals, DNB's, Charge Review and Denials

* Facilitating communication between insurance representatives, clinicians, case management, clinical staff, central business office, community physician offices and patients as needed

* Actively participating in educating and improving performance with personnel at the clinic site

* Communicating with insurance payors regarding authorization issues. May be the hospital representative at external meetings which involve HFH management.

* Ensuring that services with high risk of denial or with high charges are verified for accuracy prior to claim submission

* Managing authorization related denied claims to ensure the highest rate of payment recovery possible

* Acts as a central resource to manage, monitor and track data related to underpayments, denials and revenue opportunities to plan/implement performance improvement strategies

* Researches, develops and tests methodologies relative to special projects and quality assurance initiatives. Provides input, ideas and analyzes data for processing improvements. Supervises special project teams and coordinates tasks related to a specific section of the billing/receivable process, Additional Responsibilities for all CBO Supervisors:

* Assists with establishing quality and productivity standards for staff members.

* Provides direct supervision, scheduling, work performance/quality monitors for the staff within their assigned department.

* Interviews, hires, trains, mentors and disciplines associates according to Human Resource policies and procedures.

* Conducts midyear and annual performance evaluations per HFHS policy.

* Assists with establishing priorities and long and short-term strategic goals of the team. Ensures staff is aligned with the goals and objectives related to Revenue Cycle for the organization.

* Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and support department-based goals which contribute to the success of the organization.

* Participates in the development and revision of departmental policies and procedures.

* Participates in data collection and report analysis for performance measures, investigates and analyzes opportunities and implements solutions for optimization.

* Supports the standards set forth in the HFHS Code of Conducts by creating an atmosphere of commitment to legal and ethical standards.

* Actively involved with HFHS initiatives, such as: Service Excellence, Employee Engagement, Diversity, etc.

* Actively participates in various committees.

* Performs other related duties as assigned.