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Central Authorization: Supervisor is responsible for functions related to timely procurement of referrals and authorizations and denial management related to scheduled outpatient services..

This includes but is not limited to:

+ Performing as a central resource to proactively and continuously educate impacted staff on payor regulations/ requirements,

+ Coordinating staff work load to ensure referrals and authorizations are secured prior to patient arrival

+ Monitoring and adjusting workflow processes and work queues to ensure staff are working the appropriate accounts

+ Monitoring and maintaining acceptable work queue volumes for Referrals, DNB’s, Charge Review and Denials

+ Facilitating communication between insurance representatives, clinicians, case management, clinical staff, central business office, community physician offices and patients as needed  Actively participating in educating and improving performance with personnel at the clinic site

+ Communicating with insurance payors regarding authorization issues. May be the hospital representative at external meetings which involve HFH management.

+ Ensuring that services with high risk of denial or with high charges are verified for accuracy prior to claim submission

+ Managing authorization related denied claims to ensure the highest rate of payment recovery possible

+ Acts as a central resource to manage, monitor and track data related to underpayments, denials and revenue opportunities to plan/implement performance improvement strategies

+ Researches, develops and tests methodologies relative to special projects and quality assurance initiatives.

+ Provides input, ideas and analyzes data for processing improvements.

+ Supervises special project teams and coordinates tasks related to a specific section of the billing/receivable process

EDUCATION AND EXPERIENCE:

+ Associates degree in Business Administration, Accounting, or related field preferred.

+ Two years of experience with healthcare accounts receivable required.

+ Knowledge of best practices related to revenue cycle operations and day-to-day functionality.

+ Knowledge of CPT and diagnosis coding and Third-Party billing regulations preferred. Experience at a large, complex, integrated healthcare organization preferred.

+ Experience with insurance billing, patient accounting systems and other related applications preferred.

+ Communication skills and the ability to interact effectively with staff.

+ Ability to manage, coordinates, and leads simultaneously.

+ Ability to estimate time frames and meet projected deadlines.

+ Ability to work with a variety of individuals in executive, managerial and staff level positions.

+ Ability to work independently.

+ Ability to understand and lead change.

+ Goal oriented, exceptional interpersonal skills, change management and political skill.

Additional Information

+ Organization: Corporate Services

+ Department: CBO Central Authorization Unit

+ Shift: Day Job

+ Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.