Description
JOB PURPOSE OR MISSION: Responsible for day-to-day supervision and operation of the BRG Financial Clearance Team. Could make decisions that may affect the division, department and/or GHS System's financial and performance objectives and strategic results. May assist in the development of budget for area or provide input to manager/director on budget for area. Immediately supervises employees in an area, including responsibility for performance reviews, hiring, disciplinary actions and terminations. Performs duties for the age population served, as defined in the department's scope of service.
PERFORMANCE CRITERIA
CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.
PERFORMANCE STANDARDS:
• Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
• Takes initiative in living our Everyday Excellence values and vital signs.
• Takes initiative in identifying customer needs before the customer asks.
• Participates in teamwork willingly and with enthusiasm.
• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
• Keeps customers informed, answers customer questions and anticipates information needs of customers.
CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines and the GHS Corporate Compliance Guidelines.
PERFORMANCE STANDARDS
• Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
• Maintains accurate and reliable patient/organizational records.
• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.
CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.
PERFORMANCE STANDARDS
• Uses accepted procedures and practices to complete assignments.
• Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
• Upholds the ethical standards of the organization.
CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
PERFORMANCE STANDARDS
• Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
• Initiates or redesigns to continuously improve work processes.
• Contributes ideas and suggestions to improve approaches to work processes.
• Willingly participates in organization and/or department quality initiatives.
CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
PERFORMANCE STANDARDS
• Effectively manages time and resources
• Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.
• Consistently looks for and uses resource saving processes.
CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.
PERFORMANCE STANDARDS
• Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
• Employee proactively reports errors, potential errors, injuries or potential injuries.
• Employee demonstrates departmental specific patient and employee safety standards at all times.
• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Participates in the development of departmental goals and objectives.
PERFORMANCE STANDARDS:
• Ensures that departmental priorities are carried out on a daily basis.
• Ensures that goals and objectives of the department are administered daily and are consistent with management expectations.
• Ensures that departmental measures for processes and expectations are carried out on a daily basis.
• Assists Manager with recommending alternative methods of providing services to reduce departmental operating costs.
• Supervises the staff of the department in regards to fluctuations in the workload.
2. Demonstrates effectiveness in supervising assigned staff.
PERFORMANCE STANDARDS:
• Supervises departmental staff and processes and recommends changes as needed on a daily basis.
• Supervises operation of the department daily.
• Provides leadership to maximize the effectiveness of the work performed daily.
• Works with management and staff on data concerning the department and their activities.
3. Coordinates the daily activities of the assigned work area.
PERFORMANCE STANDARDS:
• Ensures that policies and procedures are followed.
• Coordinates the daily productivity of the department.
• Maintains an effective working relationship with administration and other departments.
• Monitors the performance improvement program for the department.
• Coordinates programs that are developed to improve departmental communications.
4. Demonstrates effectiveness in monitoring the daily activities of the department.
PERFORMANCE STANDARDS:
• Ensures that standards of performance are administered daily.
• Communicates policy interpretation to staff.
• Communicates effectively and expresses information clearly to staff.
• Maintains required records, reports and statistics as required.
• Analyzes operational data and adjusts as necessary to provide adequate, economical service.
5. Monitors and maintains accounts which are pending billing.
PERFORMANCE STANDARDS:
• Reviews reports scheduled accounts that have not been worked up with benefits, estimates, and appropriate authorizations and ensures that all accounts are completed in a timely manner.
• Monitors reports and contacts physician offices regarding scheduled procedures that do not have appropriate benefit coverage and authorizations.
• Monitors pre-bill and “bill hold” reports to make sure claims are not held and are billed within defined time lines.
• Provides accurate statistical information to departmental management as requested.
6. Performs all other duties as assigned.
SPECIFIC EXPERIENCE REQUIREMENTS
3-5 years experience in all phases of billing. 4 years experience in a Business Office environment.
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Working knowledge of hospital policy and procedure.
HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: medical record without limitation, patient demographics, lab results, patient financial and 3rd party billing information, patients related complaints, information related to patient location.
SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, exposure control plan, hand washing for all age groups.
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