The Regional Revenue Cycle Operations Supervisor is a management position responsible for supporting the Regional Revenue. Cycle Operations Manager regarding the operations success of the Regional Revenue Cycle business units to include the Medical. Centers and the Medical Office Buildings (MOB). This individual is responsible for assuring day to day operations in patient access revenue cycle processes supporting Kaiser Permanente's ability to enhance the patient experience and ensure the sustainability of the revenue cycle. Specifically, the Operations Supervisor(s) responsibility is for direct oversight of Regional Revenue Cycle Business unit(s) inclusive of: Medical Financial Assistance Program, including timely review and processing of applications and correspondence. Pre-billing and Billing operations, including management and oversight of work queues in KP HealthConnect to assist in cycle times within defined parameters. Professional Service Coding including management and oversight of work queues in KP HealthConnect (i.e., clearing of Ingenic edits). Late Discover/Subpoena/TPL operations including identification, validation and adding of coverage for Billable Payers, Kaiser Plans, Home Care and Workers' Compensation. The Outreach Program, including pre-registration and customer service/member education functions. Eligibility Unit, including completion of pre-appointment eligibility verification for inpatient and outpatient services and responsibility for resolving related work queues. Any other Revenue Cycle functions. Consistently upholds Corporate Compliance and Principles of Responsibility (Kaiser Permanente's Code of Conduct). Supervisors Responsible for Coding Functions Only: Supervisors the day-to day operations of Professional Services coding. Accountable for the timely submission of ICD9-CM, ICD10-CM, CPT and HCPCS codes as necessary and appropriate for reimbursement purposes and for coding data that meets reporting requirements for accuracy and quality and other regulatory agency requirements as required by law. Conducts on-going quality audits and monitors coders' work performance in order to ensure that appropriate medical documentation supports all code assignments required to receive appropriate reimbursement for Professional Services patient care services, treatments and procedures. Leads and provides supervision, direction and technical expertise to the coders and other assigned non-clinical personnel. Provides ongoing education and development on documentation and coding to physicians and coders based on trends and patterns identified from ongoing audit findings. Coordinates external audits and reporting to regulatory agencies including Center for Medicare and Medicaid Services (CMS), Department of Health Services (DHS), Office of Statewide Health Planning and Development (OSHPD). Ensures compliance with guidelines/requirements of t he Office of Inspector General (OIG) by ensuring accurate and compliant submission of abstracted and coded data.
• Provides day to day oversight of staff and processes, including but not limited to:
• Securing all technical and system resources.
• Recruitment of open positions.
• Local business office work migration.
• All other activities associated with creating a robust, high-functioning centralized business unit.
• Responsible for day to day supervision of the Regional Revenue Cycle business units inclusive of:
• Pre-billing operations, including management and oversight of work queues in KP HealthConnect to assist in cycle times within defined parameters.
• Billing operations, including management and oversight of work queues in KP HealthConnect to assist in cycle times within defined parameters; The Outreach Program, including pre-registration and customer service/member education functions Eligibility Unit, including completion of pre-appointment eligibility verification for inpatient and outpatient services and responsibility for resolving related work queues.
• Assumes other duties as directed.
THIS IS A REPOST OF 167108.
• Bachelor's Degree in business administration, finance, accounting, health administration or a related field or equivalent work experience.
• For the Supervision of PSC Coding Functions: Must possess certification as a Certified Professional Coder (CPC) issued by the American Association of Professional Coders.
• Three (3) years or more in a revenue cycle role including experience with integrated healthcare delivery systems and multi-facility health systems.
• Minimum one (1) year of experience in a relevant management level position.
• For the Supervision of PSC Coding Functions: Two (2) years of previous relevant experience supervising Professional Services Coders.
• Demonstrated experience in patient financial services information systems, operations improvement and re-engineering and project management required.
• Excellent working knowledge of revenue cycle operations, hospital/professional-based coding and billing experience and insurance benefits, state and federal regulations and product development.
• Excellent communication skills (written and verbal) with the ability to manage both through direct reporting relationships as well as through influence and collaboration.
• Demonstrated ability to utilize interpersonal and communication skills.
• Demonstrated ability to utilize the principles and practices of effective supervision.
• Proficient with a variety of software applications.
• Ability to demonstrate knowledge of and to utilize, apply and interpret current coding classifications systems and documentation guidelines.
• Ability to lead and achieve success in a consensus-based environment.
• Ability to analyze trends, develop and maintain performance goals.
• Skilled in coaching, counseling and developing others to achieve operational objectives including teaching the fundamentals of revenue cycle operations and objectives.
• Skilled in team building, team participation and achieving organizational success.
• Excellent written, oral and interpersonal (negotiation and listening) communication skills are required for interacting with all levels of healthcare professionals within hospitals and/or medical groups.
• Proficiency in all Microsoft computer applications (i.e., Excel, PowerPoint and Access) and other job-related networks and software.
• Operational knowledge of hospital and/or physician clinic-based revenue cycle required.
• Knowledge of general business concepts including financial management, organizational behavior and personnel/labor laws and regulations.
• Knowledge of governmental and other payer billing and collection rules and regulations.
• Must be able to work in a Labor-Management Partnership environment.
Kaiser Permanente - 18 months ago
copy to clipboard
America’s leading not-for-profit health plan, Kaiser Permanente serves more than 9 million people from 37 hospitals and 611...