Payer Services Supervisor - Louisville, United States - Trilogy Health Services
Description
JOIN TEAM TRILOGY
Weekly pay, health and dental after your first month, student loan repayment, a competitive 401(k) match, and more Make a living while you make a difference at Trilogy Health Services – a senior living provider with the continuous goal of being the Best Healthcare Company in The Midwest.
WHAT WE'RE LOOKING FOR
Job Summary:
The Payer Services Supervisor position assists the Assistant Vice President of Payer Relations in overseeing the operations of a team of centralized payer services specialist and coordinators in coordinating residents seeking medical services through insurance verifications, prior authorization, and recertifications from various insurance payers. The Payer Services Supervisor will support and assign complex payer specific tasks related to verifications, prior authorizations, and recertifications to assigned team members, while overseeing the completion. This position will be responsible for tracking and
troubleshooting issues to ensure timely approvals or verifications are obtained and limit the risk of nonpayment. The Payer Services Supervisor assists the team in completing tasks promptly and efficiently.
Roles and Responsibilities:
Supervise and lead a team of Payer Services Specialist and Authorization Coordinators.
• Ensure that the team is knowledgeable about preservice processes, insurance verification, authorizations, concurrent reviews, and other relevant tasks.
• Conduct training programs for the team to keep them informed about changes in processes, policies, and technologies.
• Collaborate with other departments such as billing, medical records, and nursing to ensure smooth patient flow and accurate information exchange.
• Identify trends and areas for improvement based on data analysis.
• Streamline workflows to enhance efficiency and accuracy.
• Collaborate with other departments, campuses, and payers to improve overall resident experience.
• Identify and implement improvements in the verification and authorization processes.
• Oversee insurance verification processes for residents, confirming coverage details, eligibility,
copayments, and any pre-authorization requirements.
• Oversee the verification of patient insurance information to ensure accurate billing.
• Address issues related to insurance coverage for billing teams.
• Develop and maintain protocols to ensure accurate and timely insurance verification for all residents.
• Ensure that insurance verification and authorization processes align with regulatory standards and facility policies.
• Collaborate with billing and coding teams to prevent billing issues related to insurance verification and authorization.
• Maintain meticulous records of insurance verifications, authorizations, and related communications.
• Manage the process of obtaining authorizations from insurance companies for medical procedures, therapies, medications, or other services rendered to residents.
• Liaise with healthcare providers, insurance companies, and resident families to facilitate authorization processes effectively.
• Generate reports on authorization statuses, denials, trends, and reimbursement issues for analysis.
• Identify areas for improvement in insurance-related processes and implement strategies to enhance efficiency and accuracy.
• Identify areas for process improvement and implement changes to enhance the efficiency and effectiveness of the prior authorization workflow.
• Other duties as assigned.
Qualifications:
Education : Bachelor Degree
Experience : 5-8 years
Physcial Requirements:
Sitting, standing, bending, reaching, stretching, stooping, walking, and moving intermittently during working hours. Must be able to lift at least 50lbs. Must be able to maintain verbal and written communication with co-workers, supervisors, residents, family members, visitors, vendors, and all business associates outside of the health campus.