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PFS Collection Supervisor

Philadelphia, PA, US, 19104

Job Type: 

1300 MKT - Wanamaker Building Req ID: 27054

Shift: Days

Employment Status: AF - Active - Regular - Full Time 

Job Summary

Supervises a team or twelve (12) Collectors and Collections Analyst in the day-to-day operations of the Patient Financial Services Department. This position provides strategic insight and recommendations on maximizing cash collections to Collections Manager and is responsible for reduction of A/R days though oversight of work assignments. Develop relationships with payor representatives to help speed resolution to adjudication problems.  Follow up with third party payors includes addressing payment delays, under payments and contract set ups.  Conduct audits of collections staff to improve efficiency and ensure compliance with organization and governmental regulations.  Monitors quality and productivity performance measures.

Job Responsibilities

Supervises operational staff responsible for various patient and third-party insurance collection functions.

  • Plans and coordinates various activities and daily workflows associated with insurance follow-up and self-pay collections.
  • Manage staff work assignments including oversight of work ques and distribution of standard department reports to ensure hospital accounts are worked.
  • Handle inquiries from staff, complete daily administrative forms submitted for approval as part of account resolution.  Forms that require extensive review include:  contractual adjustments, Charge Master Description (CDM), Contract Management Requests, Medical Records and appeals.
  • Review denial and underpayment trends in collaboration with manager and follow-up staff to develop improvement initiatives.
  • Assist with working difficult accounts escalated by staff and/management for resolution.
  • Communicate with payers, external agencies to resolve issues and foster working relationships. Document payor minutes, distribute to staff, conducts in-services and training as needed. Monitors staff production and QA scores. Measure performance; address improvement opportunities with staff.
  • Assist with preparing worksheets to submit for A/R settlements, prepare resource documents for litigation.

 

Collaborate with Patient Access, Revenue Cycle, Case Management/Utilization Review, HIM, Audit & Compliance, Specialty Centers, external collection agencies and other areas of PFS to ensure that revenue cycle flows efficiently and effectively. 

  • Identify and communicate increased revenue opportunities to Collections staff, based on analysis of existing billing, coding and reimbursement practices.
  • Identify root cause of reimbursement barriers with various entities of CHOP to resolve issues. 
  • Work with internal and/or external auditors to ensure compliance with organizational and governmental policies and procedures.
  • Audit methods and procedures of accounts receivable functions to improve efficiency.

                                           

Perform trending and analysis of Accounts Receivables.

  • Conduct root cause analysis of denials from third party insurances; trends findings and works with other areas to create and implement necessary process enhancements.
  • Complete biweekly analysis of Aged Trial Balance Reports to measure progress towards goals, identifies and resolves cash shortfalls, and directs staff in resolution of high dollar and aged accounts.
  • Provide financial analysis on issues resulting from non-compliance with managed care contracts.  Address reimbursement issues with third-party contracted payors. Advise contracting team on desirable contract terms and/or changes. Refer non-compliance to internal and external legal counsel, as appropriate.
Job Responsibilities (Continued)

Establish written policies and procedures governing operational workflow.

  • Maintain sound working knowledge of current industry concepts and practices.
  • Develop written policies and procedures based on best practices within the industry. 
  • Periodically review policies to ensure applicability to and compliance with current operational standards.

 

Proactively identify and resolve operational and system problems or issues. 

  • Recommend enhancements to the current workflow that will help to streamline the operation and provider greater service at a lower cost.
  • Identify billing system and Contract Management issues; prepares specifications for system improvements and work with Information Systems, PFS Analysts, and other pertinent parties to resolve problems.

 

General administrative responsibilities include, but are not limited to:

  • Complete bi annual and yearly impact performance reviews.
  • Monitor staff attendance and time-off to ensure adequate coverage within the departments.
  • Hire and orient new staff; trains new and existing staff.
  • Maintain staff time records and employee files.
  • Budget resources; ensure equitable distribution of work assignments. 

 

Performs other duties as assigned by Patient Financial Services leadership team.

Required Licenses, Certifications, Registrations
Required Education and Experience

Required Education: High School/GED                                                                          

 

Required Experience:

  • Minimum 3-5 years’ work experience in a healthcare reimbursement environment.
  • At least 1 –2 years supervisory experience.
Preferred Education, Experience & Cert/Lic

 

Preferred Education: Bachelor’s Degree

Additional Technical Requirements
  • Must possess strong understanding of insurance billing & reimbursement procedures.
  • Excellent interpersonal & communication skills, and demonstrated organizational and leadership abilities.
  • Requires high level of analytical ability, and strong knowledge of system analysis and data gathering techniques.
  • Ability to work independently towards specific goals and objectives and provide recommendations for improvement. 
  • Knowledge of computers, specifically healthcare, word-processing and spreadsheet applications. 

All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.

Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products or nicotine in any form and a negative nicotine screen (the latter occurs after a job offer).

Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.

VEVRAA Federal Contractor/Seeking priority referrals for protected veterans.  Please contact our hiring official with any referrals or questions.

CHOP Careers Contact 

Talent Acquisition

2716 South Street, 6th Floor

Philadelphia, PA 19146 

Phone: 866-820-9288 

Email:TalentAcquisition@email.chop.edu

 

 

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