Job Description

Job Summary:

Serves as expert and resource to staff for the creation of professional fee encounters. Ensures timely and accurate creation of professional fee encounters. Audits encounters regularly and provides feedback to associates. Ensures financial clearance of clinic non-office encounters are accurate, complete and timely, including, but not limited to insurance verification, demographics and authorization is secured. Manages the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgement. Works on routine assignments within defined parameters, established guidelines and precedents. Works closely with clinic leaders and providers to ensure timely and accurate RVU assignment. Coordinates and implements orientation, training, and continuing education for pre-services staff.

Job Requirements:

Education and Work Experience:

• Bachelor's Degree or equivalent combination of education/related experience: Required
• Master's Degree: Preferred
• Five years' relevant experience: Preferred
• One year leadership experience: Preferred

Essential Functions:

• Works directly with clinic leaders and providers to ensure proper workflows are followed. Travels, as needed, to clinics to meet with clinic leaders and providers to assist with education on workflows and RVU capture process and concerns. Ensures that team members have configured daily reports to obtain all provider's signed notes, leveraging reports to create clinic non-office encounters accurately and timely.
• Notifies staff of any provider changes that require updates to reports used to create encounters. Stays abreast of provider changes, payer changes and requirements and educates staff as needed. Works with clinic authorization staff to ensure authorization information is entered into the correct location in the revenue cycle application. Ensures clinics and providers abide by standard processes for providers who work outside of Adventist Health facilities.
• Acts as subject matter expert in clinic non-office registration practices. Ensures return queues are worked timely. Reviews denials and actively works to reduce denials that are a result of inaccurately registered encounters. Sets goals for staff to achieve and regularly monitors performance to goals. Ensures staff are compliant with AH policies and procedures, including staying up to date with Healthstream assignments.
• Manages the activities of pre-services staff and coordinates care with other disciplines while utilizing critical thinking, professional and supervisory discretion, and independent judgment.
• Delegates appropriately and coordinates duties of pre-services supervisor and staff.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.