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Pre-Certification Supervisor
Northeast Georgia Health System. Report directly to the Manager of Precertification .
About the role
Key responsibilities & impact- Report directly to the Manager of Precertification
- Oversee inpatient and outpatient scheduled procedures and admissions, insurance verification, and monitoring of pre-certification-related denials
- Collaborate with Financial Counseling, Physician Offices, Clinical Service Lines, Case Management, UR, and PFS
- Assist with timekeeping, train new hires and provide remedial training for current employees
- Trend errors, update Standard of Works, and enforce NGHS policies, IT processes, and Patient Access policies and procedures
- Develop educational tools, including paper handouts, HealthStream courses, and physician website help pages
- Provide one-on-one and small-group training
- Resolve Claim Edit Workqueue accounts and keep them below the established goal
- Trend improvement work, employee issues, and denials to address barriers
- Ensure daily staffing plans adequately cover patient demand
- Track and trend data, create workflows, and develop process-improvement metrics
- Anticipate and resolve routine issues and provide input to leadership and the System Administrator Revenue Cycle
- Coordinate physician and physician-office service requests and incident resolutions
- Provide on-call support and visits to physician offices as needed
- Provide visibility and support during planned and unplanned downtimes
- Assess staff educational needs and develop and implement training plans
- Collaborate to optimize current systems and assist with future hospital system implementation
- Participate in special projects, committees, task forces, and meetings
- Provide employee feedback to the manager for evaluations
- Evaluate the effectiveness of education programs using aggregate data, research, and trends
Requirements
What you’ll need- CPC Certification required; AAPC or AHIMA certification accepted
- High School Diploma required
- Five (5) years of related pre-certification / insurance verification experience
- Two (2) years of progressive leadership experience required
- Ability to test, analyze, troubleshoot, and isolate complex problems
- Competency in Microsoft Office products, including Word, Excel, Microsoft Project, and PowerPoint
- Excellent interpersonal, written, and oral communication skills
- Excellent time management skills
- Detail-oriented and able to multitask
- Understanding of Revenue Cycle and regulatory guidelines such as CMS, EMTALA, and HIPAA
- Ability to read, write, reason, talk, keyboard, and drive
- Ability to lift and carry up to 20 lbs occasionally
- Bachelor's Degree preferred
Benefits
Comp & perks- Equal Opportunity Employer commitment and non-discrimination in employment
- Opportunities for personal, employee, and professional growth