Sup WMG PAS Central Precertification
Wellstar Health Systems

Job Info

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Facility: WAB - Wellstar Administrative Building

Job Summary:

The Central Pre-certification Supervisor position leads the daily operations of their assigned areas under the supervision of the department Manager/Director, including ensuring appropriate staffing, assisting with problem solving and customer service issues, and ensuring policies and procedures are being followed.
The Central Precertification Supervisor position functions under the direction of the Precertification Manager and/or Director.
Key Responsibilities of the role includes:
Assists the PAS Manager and/or Director with monitoring, maintaining and evaluating key performance indicators (including quality, collections, productivity, and patient satisfaction), and developing and implementing action plans for optimum performance. Works well with other team members to ensure all areas are staffed appropriate to volumes. The Central Pre-certification Supervisor will serve in a front-line position when the need arise, covering open shifts as appropriate. The position assists the PAS Manager and/or Director with other duties as required to help ensure the efficiency of the department. Demonstrates professionalism, effective communication skills and active listening skills. Assist with preparing staff schedules and coverage needs. Monitors request to initiate and complete precertification by staff. Completes monthly work queue and documentation audits. Assist with Work queues resolution. Assist with training initiatives and project development. The Central Pre-certification supervisor is responsible for handling daily responsibilities in conjunction with other departments.
The Central Pre-certification supervisor will be responsible for direct supervision of WMG PAS Central pre-certification staff and/or Team Leads.
Impact of this role in the organization:
Impact to the organization is this offers better Customer Service to departments in the absence of the Supervisor/Manager. Assist staff with patient/doctor problems and/or complaints. Attend any meetings necessary on behalf of Supervisor/Manager/Director when feasible.

Core Responsibilities and Essential Functions:

Leadership a.Facilitates a positive work environment and assists with the development and motivation of employees. b.Attends departmental, system-wide and/or interdepartmental meetings as needed. c.Leads by example, assisting in projects, working as a positive team member, and rounding and mentoring of staff for optimal performance. d.Works to meet Wellstar goals related to Employee Engagement and Employee Turnover. e.Improve departmental performance metrics. f.Monitors patient throughput and adjusts staffing and processes as appropriate to ensure the most efficient workload coverage throughout department. Quality/ Safety a.Implementation and training of new programs/updates to employees. b.Responsible for quality and performance monitoring and reporting. Compiles and distributes data from management reports in a timely and accurate manner. Works with manager to analyze data to make changes as appropriate. c.Takes initiative to appropriately investigate and resolve department issues as they arise. d.Understands and enforces policies and procedures for assigned areas. e.Assists with investigating account issues, such as denials, tracking and trending problems, and implementing changes and education as appropriate. f.Assists with meeting all quality goals (i.e. patient throughput). g.Monitors and ensures maintenance of accounts, DNB/Denials, claim, patient, and other related Workqueues that impact the Revenue Cycle. h.Participate monthly Denial resolution for respective WMG Practices and Facilities. i.Ensures quality and drives resolution of initiatives which impact the overall health of the Revenue Cycle. Resolves errors and applicable Claim, DNB and Patient WorkQueues. Planning a.Participates in department, committees and special projects and assumes accountability as appropriate. b.Participates in meeting the goals and objectives of the Central Precert department. c.Collaborates with Revenue Cycle leadership to develop and implement goals, objectives and 90 day Action Plans for the department. d.Represents the department at various WMG BO meetings and functions. e.Participates in special projects. Assumes accountability. Responsible for the ongoing management of daily operational functions of the department. Customer Service a.Participates in customer service teams. b.Resolves patient, physician, interdepartmental and other customer issues in a timely and appropriate manner. c.Demonstrates ability to tactfully handle difficult situations through an approach that reflects consistency. d.Monitors facility and area customer service scores, and works with management team on action plan. e.Maintains positive relationships with other department personnel. f.Pursues excellence in all areas related to customer service, including service recovery. Expected Performance, Behaviors and Results: The WellStar Experience (Must demonstrate a commitment to Service Excellence by): Creating first impressions, memorable moments and impressions that fulfill the expressed and unexpressed wishes and needs of patients and family members. Valuing patients and family members as partners in their care. Having world-class processes in place. Delivering high-touch care that is reliable, responsive and coordinated. Focusing on constant innovation and creating improvements. Celebrating our diversity with sensitivity and understanding. a.- Embracing the idea that we are all owners of our health system.

Required Minimum Education:

High school diploma Required or
General Educational Diploma (GED), in addition to 2 years post-secondary education.
Required and
Bachelor's Degree Preferred

Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.

• Cert Healthcare Access Assoc or Certified Patient Account Rep or Certified Revenue Cycle Rep

Additional License(s) and Certification(s):

Required Minimum Experience:

minimum 5 years of experience in Precertification.
Required and
minimum 5 years experience in healthcare Revenue Cycle; Required and
Bachelors degree or higher may substitute for experience.
Required and
Epic and 3M experience Preferred

Required Minimum Skills:

Proficient in current EMR system.
Effective communication skills (both written and verbal), attention to detail, self-directed and a positive attitude are essential.
Effective problem solving and critical thinking skills.
Computer/data entry experience.
Ability to communicate with various members of the healthcare team.
Ability to use EXCEL, Word and have basic computer operational knowledge.

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