Medical Staff Supervisor Full-Time
4 weeks ago
We are seeking a highly skilled Medical Staff Supervisor Full-Time to join our team at Corewell Health. This role is responsible for supervising the provider contract reimbursement set up and ensuring the configuration aligns with the provider payment and billing policies.
Key Responsibilities- Supervise Provider Contract Reimbursement: Ensure the configuration aligns with provider payment and billing policies.
- Manage Department Objectives: Create, maintain, and monitor policies, procedures, metrics, and guidelines.
- Collaborate with Teams: Work with provider network contracting and provider enrollment teams to ensure high levels of quality and efficient work.
- Lead Problem-Solving: Accountable for resolution of implementation and support issues, and lead collaboration with support teams to troubleshoot and resolve escalated incidents.
- Mentor and Train: Mentor new staff and less experienced team members, and serve as a role model for customer service excellence.
- Stay Up-to-Date: Monitor federal regulatory changes and other appropriate sources for rule revisions associated with payment policies.
- Lead Small-Scale Projects: Identify tasks, dependencies, responsibilities, quality checks, and milestones for small-scale project and process implementation.
- Support Value Stream Teams: Analyze business functional details requirements for complex corporate initiatives and help articulate technical and business non-functional requirements.
- Extensive Knowledge: Have extensive and comprehensive knowledge of business processes, including provider reimbursement methodologies, provider data, provider networks, and claims processing.
- Strong Analytical Skills: Possess strong analytical and systems/relational analysis skills.
- Facets Medical Agreement Application: Have knowledge of Facets Medical Agreement application and NetworX application.
- Bachelor's Degree: Bachelor's Degree or equivalent.
- Experience: 3 years of relevant experience working with UB04 facility billing or professional CMS-1500 billing, 3 years of relevant experience working with provider reimbursement methods in Medicare/Medicaid/Commercial spaces, and 7 years of relevant experience using Microsoft applications including Word, PowerPoint, Excel, and Business Objects.
- Skills: In-depth knowledge of Facets data structures, systems flows, and process flows, including knowledge of third-party integrated and target systems, and ability to use SQL for data to support decision-making.
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