Program Supervisor III

4 weeks ago


San Antonio, United States Texas Department of Aging & Disability Services Full time
Job Description:
Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of each other, teamwork, and inclusivity? HSCS is dedicated to building a diverse community atmosphere where employees feel valued, supported, and accepted while providing specialized care for Texans in need. If providing hope and healing through compassionate, innovative, and individualized care interest you, we welcome your application for the position below.

Assistant Director (Program Supervisor III), under the supervision of the Reimbursement Director, performs highly responsible administrative and management tasks in planning, directing, and monitoring the activities of the Reimbursement Department for the San Antonio State Hospital (SASH). Work involves assisting the Director in planning and developing reimbursement programs, developing performance improvement goals for the department, interpreting state and federal regulation, and providing coordination and liaison with other state and federal agencies and agency sections concerning mental health reimbursement programs.

Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Essential Job Functions:
1. Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.
2. Ensures staff participates in mandatory training in order to ensure staff competence and development.
3. Plans and develops the reimbursement program through the direct supervision of the Department Director.
4. Keeps informed of state and federal laws, regulations, and rules affecting reimbursement.
5. Maintains liaison with representatives of the Department of Human Services, Department of Health, Social Security Administration, Health Care Financing Administration, and other state, federal, and private entities as required to ensure the proper coordination of the reimbursement program.
6. Coordinates the intake and documentation of financial and demographic data associated with admissions to state mental health facility. Identifies and confirms potential sources of reimbursement.
7. Assures that consents to release information are obtained as required by rules of the department.
8. Retains documentation that Medicare beneficiaries are informed about decisions affecting their Medicare coverage and payment for facility based services.
9. Determines rates charged to individuals having an ability to pay. Assesses persons served for indigence. Documents rationale for determinations on contact logs.
10. Establishes or supervises the preparation of source of fund accounts in mainframe data processing system. Enters or supervises the entry of financial transactions on established accounts in BHIS, including collections, adjustments and write-offs. Assumes responsibility for accuracy of system-generated logs and reports.
11. Ensures activities necessary to collect Medicare Part A reimbursement. Coordinates and prioritizes claim submission when other third party resources exist. Ensures correct calculation of covered and non-covered days, correct submission of claims through CRS billing system, and accurate posting of payments, adjustments, recoupments and bad debts to logs.
12. Oversees and ensures activities necessary to collect Medicare Part B reimbursement for ancillary, physicians’ and psychologists’ services. Directs the submission of claims using pre-based systems and ensures correct posting of payments, adjustments and recoupments to CRS accounts.
13. Ensures correct submission of claims into mainframe billing system and accurate posting of payments, adjustments, recoupments and bad debts to logs. Assists with medical record preparation necessary for regular post-pay audits required by the intermediary for reimbursements for therapy services.
14. Oversees and ensures activities necessary for reimbursement by Medicaid for inpatient services to eligible persons under 21 years of age. Coordinates documentation by clinical staff necessary to obtain authorization. Prepares additional documentation upon request. Monitors number of days authorized and status of beneficiaries to initiate follow-up requests.
15. Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Knowledge Skills Abilities:
1. Considerable knowledge in Medicare Part A billing, health related accounting and collection procedures, and use of automated data processing in such procedures; of personnel management and office practices; and of federal and state laws, government regulations and agency rules governing reimbursement for agency services.
2. Ability to establish and maintain effective working relationships with associates, supervisors, and governmental and non-governmental agency personnel.
3. Ability to achieve understanding and effective relationships with clients and persons legally responsible for clients.
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