Reimbursement Supervisor - Ophthalmology Insurance/Auth

WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! 

JOB SUMMARY
The Reimbursement Supervisor in Ophthalmology works under limited supervision to be responsible for providing assistance and training to staff on coding, compliance, and billing issues, maintaining proper coding and compliance procedures for division, and supervising daily operations of departmental billing. 

 

BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer
• Learn more about these and other UTSW employee benefits!

EXPERIENCE AND EDUCATION

Required

• Education
  High School Diploma or GED 
   

• Experience
  7 years of experience in physician practice plan, healthcare, or medical insurance environment to include 
  2 years of supervisory (either direct or indirect) experience, and previous exposure to hospital or physician billing 
   

Preferred

• Licenses and Certifications
  (CPC) CERT PROFESSIONAL CODER Certified Professional Coder (CPC) Upon Hire or
  (CCS) CERT CODING SPECIALIST Certified Coding Specialist (CCS) Upon Hire or
  Advanced Records Technician (ART) Upon Hire or
  (RRA) REGISTERED RECORDS ADMIN Registered Records Administrator (RRA) Upon Hire 
   

JOB DUTIES

• Oversee department insurance verification/procedure authorization work queues to ensure department metrics are met
  • Maintains department productivity standards
• Lead training sessions for direct reports, clinic staff employees and supervisors on fundamentals of Insurance Verification, payer updates, provider credentialing status, and workflow updates.
  • Training sessions to include 1:1, CSA group training, in-person/Teams.
  • Oversees staff development, such as continuing education and cross training.
  • Develops training based on clinic staff practice needs.
  • Ensuring insurance verification/authorization resources are continuously updated
  • Train and act as a resource to clinic-based CSA dedicated to support the clinic in insurance/authorization/referral related issues.
    • Collaborate with CSA Supervisors to guide this staff member in supporting the clinic.
• Create and maintains in-office/outpatient sx/procedure trackers, copay assistance patient trackers
  • Retrieving and distributing foundation payments for in-office injections
• Coach staff on strategies to improve efficiency and performance to improve patient satisfaction
  • Works with assigned staff on Productivity numbers, tracking, etc.
• Assist in the development and implementation of policies/SOPs
• On-boards and trains new employees
• Demonstrates ongoing competency skills including above level problem solving skills and decision-making abilities
• Promotes team engagement
• Manage team / staff schedules to ensure appropriate coverage.
• Distribute workload among the team, re-evaluating periodically.
• Thorough documentation of staff education, 1 on 1 communications, etc.
• Periodic shadowing, review of workflows and processes to identify opportunities for improvement and update SOPs as needed.
• Manage timecards and time off requests for assigned staff in partnership with other Supervisors and Manager to ensure proper coverage and plan.
• Guide team on proper approaches (verification, authorizations, referrals, Epic processes, denial follow up, charge entry, and other processes).
• Work with staff to establish goals, complete staff evaluations and complete quality control activities; develops and/or approves schedules, priorities, and standards for achieving goals. 
• Work catch-up projects, help cover staff absences, etc., when needed.
  • Ensuring projects relating to insurance verification/procedure authorizations are completed on time and changes are implemented appropriately
• Performs other duties as assigned

SECURITY AND EEO STATEMENT

Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.

EEO
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.