Supervisor, Pfs

Job Details

Job Location:

Cullman Regional Medical Center - Cullman, AL 35056

Position Type:
Full Time

Job Shift: Day

Job Category:
Health Care

• Ensure accurate and complete posting test, entering orders, verifying medical necessity, and confirming precertification.
• Assist with obtaining new orders if medical necessity is not met and/or pre-certifications are not obtained.
• Verify all physician orders have required information (Physician signature, patient's full name, DOB, diagnosis/reason, and date) and are scanned into hospital system.
• Work with access and/or physician offices to assure late add-ons are managed properly.
• Review next day schedules to confirm all patients are completed and obtain any additional information needed.
• Communicate regularly to update and validate comprehension by staff of scheduling guidelines from all scheduling centers and adhere to all procedural protocols.
• Monitor daily workflow and staff productivity to ensure departmental goals and performance standards are met.
• Oversee claim submission and follow-up processes to minimize denials, delays, and outstanding accounts receivable.
• Review denied and rejected claims, working with the team to identify root causes and develop corrective action plans to improve reimbursement.
• Ensure timely and accurate resolution of billing discrepancies, claim edits, payer issues, and patient account concerns.
• Develop staff education and training related to billing procedures, payer requirements, denials, and revenue cycle processes.
• Serve as a resource and escalation point for complex billing and reimbursement issues.
• Assist management with staffing, scheduling, workflow development, and departmental policies.
• Ensure staff is trained/updated on CPT changes, insurance precertification requirements and medical necessity changes.
• Manage to ensure department is adequately staffed and new employees are thoroughly trained.
• Demonstrate and encourage team behavior and exceptional patient/guest experiences.
• Uphold and promote patient safety and quality.

High school diploma or equivalent required. Certification or associate's degree in coding is preferred. Must have in-depth knowledge of medical terminology.

Two years' medical terminology experience required; supervisory experience preferred. Phone experience and previous medical office experience are preferred.

• Computer experience required.
• Must be able to type 30 WPM.
• Must be able to communicate well with physician office staff and adjoining departments within organization.
• Must be able to develop and implement policy and procedures and training documents as needed by the department.