Revenue Cycle Supervisor - Casa DaVita ( Irvine, CA )

Job Description:

This position assists the Revenue Manager in the supervision of patient admissions, billing and collections activities of a team responsible for the accounts receivable of assigned dialysis centers within a geographic region in accordance with company policies and in compliance with federal and state billing regulations. ESSENTIAL DUTIES AND RESPONSIBILITIES:The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive. Team OversightMonitor work of Revenue Associate's and Patient Access Associate's to: Ensure that accounts receivable is an accurate reflection of what is collectible and that teammates identify and adjust uncollectible balances accurately and timely with the appropriate approvals Ensure timely submission of primary, secondary and tertiary insurance claims Ensure AR exceptions are solved at root cause Ensure timely and accurate patient registrations including insurance verification, authorization, referrals, and ongoing maintenance of eligibility with existing patients Review and approve adjustments as appropriate Ensure team follows documented policies and procedures, including SOX narratives, and conduct SOX control activities, as appropriate Supervise daily activities of direct reports Provide clear and direct guidance to teammates on questions and expectations Attend meetings and make presentations as needed Assimilate new staff into department. Administrative duties for new hire - email communications, meet and greet, budget changes, action notices etc. Ongoing training for existing team Monitor performance of team. Continue to create metrics and yearly goals. 1-1 meetings to discuss progress, issues, career path. Continued mentoring of team. Analytics / StrategyReview daily, weekly and monthly key metrics to identify trends or areas of focus; work with Revenue Manager to develop, document and implement action plans, as appropriate, to address issues Establish and facilitate regularly scheduled meetings with manager to discuss key success metrics regarding billing activity, DSO, account setup requests, denials and A/R reports Maintain current and thorough understanding of dialysis reimbursement and industry norms; monitor payment trends, escalating issues, concerns and changes in payer behavior reporting as appropriate to Revenue Manager Maintain current familiarity with payor contracts applicable to the geographic / contractual responsibilities of the team Facilitate STAR cross-functional meetings; follow-up on action items and drive resolution Capture key findings from STAR program activities and track progress of each finding Compile monthly Operations Reviews based on analytics and input from team Effectively resolve and/or orchestrate across the revenue cycle all issues or concerns regarding claims processing and billing issues. Proactively anticipate upcoming concerns/events and work with assigned center / payors to prevent/mitigate AR duties / OtherInitiate collection follow-up of all unpaid or denied claims with the appropriate Payor Research, appeal, and resolve claim rejections, underpayments, and denials with appropriate payor Respond to payor communications with appropriate action in timely manner Identify root cause of claim exceptions - resolve - and / or escalate issues as appropriate for prompt and effective resolution Maintain knowledge of ESRD/MSP laws and changes Ensure new patient insurance records are established timely and accurately and maintained properly to ensure accurate billing for treatments and services provided Ensure the timely procurement of initial payor authorizations and reauthorizations for treatments and services provided to ensure payment to DaVita Coordinate responsibilities related to insurance verification and billing needs for newly-acquired centers and DeNovos Minimize bad debt by ensuring timely follow-up of unpaid claims, resolution of denials and other payer-related correspondence Collaborate closely (in conjunction with Manager) with internal Revenue Operations teams to obtain needed information / updates to bill payors Develop and maintain strong relationships with internal operational constituents Monitor Direct Data Entry Internet access into Medicare claims system to ensure timely and accurate resolution of outstanding claims Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies Drive special projects and other responsibilities as assigned Some light travel required