Job Title

Supervisor Insurance ProgramClick Here to Apply OnlineJob DescriptionLocation: Saint Anne's HospitalPosted Date: 9/17/2024Job Type: Full TimeDepartment: 0201.72080 SAH Credit and CollectionPOSITION SUMMARY:Oversees all aspects of the Insurance Program Specialist objections and is responsible for the daily oversight and reconciliation of all self-pay patients. Responsible for securing payment solutions for uninsured / underinsured patients to enable them to meet their financial obligations. Works with the director to establish goals, priorities and performance standards and monitors and measures operational metrics, including screening and insurance solutions for uninsured patients, quality, productivity, customer service and collections. Ensures the integrity of all data collected at time of service to ensure accurate patient identification / benefits information and personally collects and/or facilitates the accurate and timely payment for services provided by leveraging available private / public insurance solutions. Negotiates payment arrangements and secures payment plans for self-pay patient or patients with identified out- of-pocket expenses. Delivers superior internal and external customer service.KEY RESPONSIBILITIESCoordinates and oversees training of all new staff on required competencies, including providing education and preparing new staff for the Massachusetts and Rhode Island state required Certified Application Counselor examsEnsures all training manuals and training curricula are up to date and readily accessibleCoordinates schedule of staff and assists director in covering unexpected absences to ensure staffing compliment meets demands of department.Assists director with coordination of scheduled vacationsOrients and trains staff on all hospital operating systems including: Meditech; Revenue Protect; MA Health Connector via Optum; Virtual Gateway; Health Source of RI; various payer eligibility tools.Responsible for the ordering of supplies from bulk stores and online Steward approved vendors and ensuring the department always has an adequate supply of items neededCoordinates the transfer of confidential documents including PHI (Personal Health Information) to Steward approved vendor to storage for required seven yearsResponsible for the daily oversight and reconciliation of all self pay patients, ensuring all have been seen and counseled on their eligibility for and availability of health insurance plansWorks closely with and effectively communicates to internal and external customers (e.g., patient access, case management, social work, physician offices, insurance carriers, state Medicaid offices) to ensure alignment and customer satisfactionWorks closely with staff and director to facilitate a team environment where collaboration is fostered Screens all self pay patients, identifies solution(s) and facilitates patient payment and/or solution application process (manual and/or electronic)Collects and verifies patient demographic, insurance eligibility, and financial information/responsibility and accurately documents in hospital computer system(s)Follows up and obtains all documentation required for application processing and accurately enters information into hospital and external systems as appropriateIdentifies via workflow technology current and prior patient responsible balances, educates patients on their financial responsibilities, and collects sameAssists patients in establishing secured installments plans when applicableInterviews patients bedside as needed to facilitate timely and effective payments and/or complete insurance solution application processMonitors, manages and actively follows up on active self pay accounts to ensure solutions / solution modifications in place for patients and optimize ultimate payment for the hospital.Establishes schedule for 'walk-in' insurance assistance applicants and facilitates application process for same Fields patient billing inquiries and refers to appropriate PFS staff for resolutionResponsible for consistent and accurate use and execution department procedures and protocols and supporting tools, software, websitesMeets performance standards established by Patient Access leadership, including but not limited to: quality, collections, customer service, screening/solution rates and productivityKeeps current with all internal and external policy and procedures that may affect reimbursementDelivers exemplary customer service for patients in accordance with hospital expectations / guidelinesDemonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional , responsible and courteous environmentCommits to recognize cultural diversity and communicate effectively with internal and external customers with respect of differences in culture, values, beliefs and agesPerforms all other duties as assigned.REQUIRED KNOWLEDGE & SKILLS:Maintains detailed knowledge of private, public and third-party payer insurance and related regulationsFamiliarity with Massachusetts Medicaid eligibility requirements, and a detailed knowledge of navigation of insurance application processKnowledge to educate others on state and federally offered insurance programsDetailed knowledge of medical terminologyOutstanding communication and interpersonal in a customer service-based health care settingAbility to work with a high degree of confidentiality.Familiarity with Meditech preferredDetailed knowledge of Microsoft Office toolsComprehensive knowledge of tools, systems, and technologies to enable insurance verification and facilitate insurance solutionsExperience with securing solutions for uninsured patientsDetailed knowledge of health insurance and reimbursement/billing requiredAbility to problem solve and follow through under ambiguous circumstancesAbility to show empathy and encouragement to patients and their family membersBilingual in Portuguese preferredEDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER: Education: Associate's degree preferred. High School Diploma or equivalent required. Experience: 4-6 years in hospital or community health center registration/billing office/clinic and with a current detailed knowledge of Massachusetts Medicaid eligibility and insurance program optionsCertification/Licensure: Must have Certified Application Counselor (CAC) certification in Massachusetts and Rhode Island. Recertification is required yearlyAdditional InformationEqual Opportunity EmployerSaint Anne's Hospital is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.Application InstructionsPlease click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you