Supervisor Insurance Follow-Up
Company: Boys Town National Research Hospital
Posted on: March 20, 2023
Supervises all staff and functions for insurance denials
management and follow up within patient financial services office.
Serves as the overall Boys Town National Research Hospital (BTNRH)
insurance billing expert and point of escalation, to include
supervising follow-up specialist staff and processes to resolve
unpaid, denied, or incorrectly paid insurance claims, including
necessary refunds. Supervises workflows for insurance follow-up
staff, research payer issues that result in denials and presents
findings for payer trends to PFS leadership. SCHEDULE:
Monday-Friday 8a-5p MAJOR RESPONSIBILITIES & DUTIES:
- Facilitates and provides direct oversight to Insurance
Follow-Up Specialists, serving as the groups liaison with other
billing office groups, as well as departments and leaders outside
of PFS as it relates to insurance billing, denials, aged A/R,
rejections, credits, and underpayments.
- Accountable for providing ample orientation and ongoing
training of Insurance Follow-Up Specialists.
- Continuously monitors follow-up specialist's staff's workloads
and assignments, to ensure no A/R is unassigned, and that staff
assignments are set-up in such a way to avoid all timely filing and
appeals adjustments at or below set performance standards, as set
forth by the Patient Financial Services Director.
- Performs monthly audits of personnels productivity and ensures
quality at the departments defined standards. Compiles audit
results and findings, tracks and trends each staffs ongoing results
and communicates findings to management, while coaching and
mentoring staff when below standard results and trends exist.
- Tracks, trends, analyzes and implements changes to fix/reduce
payer denials and rejections. This includes using system and
workflow updates, education of staff and work with payer
representatives and management to achieve goals (quarterly and
annual) within the patient financial services office, focusing on
effectiveness and efficiency.
- Maintains current knowledge of various payer specific contracts
and policies, as they relate to denials and rejections, as well as
ensuring staff is kept abreast of pertinent payer information
allowing the staff to ensure BTNRH is being reimbursed correctly,
while having the ability to make sound business decisions based on
the current payer contract information.
- Assists in related system design, build, validation and
training specific to contract management and communicates
information necessary for follow up/appeal if the payer response
received is incorrect.
- Runs, validates and distributes insurance follow up denials,
rejections, performance, and production to staff and management on
- Maintains supervision of insurance credit balances, ensuring
the staff works the credit balances within the compliance
guidelines of BTNRH.
- Actively fosters excellent teamwork to assist in achieving the
mission, while offering assistance to solving complex problems
while responding effectively to crisis and unplanned events in a
timely and confidential manner.
- Oversees the interviewing, selection, evaluation of performance
and coaching of Insurance Follow-Up Specialists.
- Manages direct reports timecards on a weekly basis, minimizing
overtime situations and consulting employees of discrepancies when
- Communicates appropriately using good interpersonal skills,
ensuring that a positive, professional demeanor is projected
through verbal and non-verbal communications, ensuring information
for patients is delivered in a manner that is supportive, timely
and understandable.Reviews adjustment requests for completion and
accuracy from insurance follow-up specialists, approves and routes
adjustments correctly within the appropriate approval and
turnaround time guidelines, as determined by the PFS Director.
KNOWLEDGE, SKILLS, AND ABILITIES:
- Communicate professionally, clearly and concisely, both orally
and in writing, with all BTNRH staff, physicians and patients in
all aspects of the job to allow for high levels of efficiency and
promptness for patient care.
- Function independently and with limited supervision.
- Knowledge in UB92, HCFA 1500 Hospital Insurance Claims forms
and their requirements, which includes in depth knowledge of the
most current version of ANSI 837 electronic claims files, loops and
segments, along with understanding of CPT, HCPCS, ICD10 as related
to denials and payments.
- Knowledge in claims clearinghouse capabilities and related
build and set up.
- Problem solve, and to apply exceptional analytical skills to
creatively resolve issues and organize workload according to
- Strong attention to detail, goal oriented and confidence in
making independent decisions.
- Knowledge of denials and their effect on revenue cycle
- Knowledge of Microsoft PC applications, such as Outlook, Word
- Serve as a positive role model for the billing office and to
support the mission of BTNRH. REQUIRED QUALIFICATIONS:
- High school diploma or equivalent required.
- Minimum of 5 years experience in health care, with focus on
hospital claims/denials required.
- Extensive experience in healthcare billing, reimbursement
issues and rules and regulations for insurance payers is
- Previous lead or supervisory experience required. About Boys
Town: Boys Town has been changing the way America cares for
children and families since 1917. With over a century of service,
our employees have helped us grow from a small boardinghouse in
downtown Omaha, Nebraska, into one of the largest national child
and family care organizations in the country. With the addition of
Boys Town National Research Hospital in 1977, our services branched
out into the health care and research fields, offering even more
career opportunities to those looking to make a real difference.
Our employees are our supporters when it comes to achieving Boys
Town's mission, which is why we are proud of their commitment to
making the world a better place for children, families, patients,
and communities. Unique perks to Boys Town employees and their
families include free visits to Boys Town physicians and free
prescriptions under the Boys Town Medical Plan, tuition assistance,
parenting resources from our experts and professional development
opportunities within the organization, just to name a few. Working
at Boys Town is more than just a job, it is a way of life. This
advertisement describes the general nature of work to be performed
and does not include an exhaustive list of all duties, skills, or
abilities required. Boys Town is an equal employment opportunity
employer and participates in the E-Verify program. All qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, sexual orientation, gender identity
and/or expression, national origin, age, disability, or veteran
status. To request a disability-related accommodation in the
application process, contact us at 1-.
Keywords: Boys Town National Research Hospital, Omaha , Supervisor Insurance Follow-Up, Other , Omaha, Nebraska
Didn't find what you're looking for? Search again!
Loading more jobs...