Job Summary:

The PFS Supervisor is responsible for the day-to-day operations of certain assigned work units within the PFS Department. The PFS Supervisor is responsible for managing all end-to-end processes in the PFS Department and ensuring proper coordination and integration with all upstream, revenue cycle processes. PFS has work units that currently perform the following: identification and primacy determination of third-party billing opportunities (Medicare, Other Insurance Coverage (OIC), Workers Compensation, and Third-Party Liability situations); the billing of charges to these entities; the collection of accounts receivable from these entities; the billing and collections of all member and non-member self-pay balances; and, the application of all payments to the Kaiser Mid-Atlantic patient accounting system.

Essential Responsibilities:

• Directly manages the staff in the assigned work units. Is responsible for hiring and all disciplinary actions up to and including termination of subordinates in accordance with EEO/AA, union contracts, and personnel policies.

• Develops and implements standards of work (SOW) consistent with National and Regional KP policies. Ensures that all employees are properly trained and adhere to all applicable standards of work (SOW), policies and procedures once implemented.

• Develops comprehensive unit and employee goals to motivate staff and support departmental objectives. Ensures that financial goals are met and that all employees reach all performance metric targets and departmental production standards of quantity and quality as set forth by the PFS Director.

• Assists in developing specifications for new reports. Reviews and analyzes operational reports to monitor productivity, identify trends, explain variances and manage performance.

• Leads and/or manages projects that are cross functional. Provides consulting support and acts as a subject matter expert with project managers and leadership, as required.

• Supervises back-end revenue cycle activities. Regularly evaluates existing workflows, business systems and processes to identify improvement opportunities for streamlining operations and increasing revenue and productivity.

• Ensures that the unit operations and business practices are conducted in a manner that is compliant with regulatory requirements for all applicable jurisdictions.

• Integrates front and middle-end revenue cycle activities with PFS processes. Works closely with other departments, such as General Accounting, Accounts Payable, Membership Services, Claims, HIMS, Appeals, Fraud & Abuse, and Legal, to coordinate the flow of information involving payment of medical bills and/or financial liability.

• Ensures that all employees interacting with members are conducting themselves in a courteous and professional manner.

• Ensures that all employee follow the time collection process, including the KRONOS automated time and attendance systems for a designated Region.

• Perform other duties as assigned.

  Basic Qualifications:

  Experience

• Minimum five (5) years of experience in healthcare provider billing and collections.

• Minimum one (1) year of supervisory/management experience OR minimum two (2) years of experience in one of the various PFS Coordinator positions OR minimum of two (2) years of experience and expertise in medical billing, collections and back-end revenue cycle activities required.

• Minimum one (1) year of knowledge of accounting principles, especially as related to accounts receivables required.

  Education

• Associates degree in business administration, finance, healthcare administration or a related field required, OR two (2) years of experience in a directly related field.

• High School Diploma or General Education Development (GED) required.

  License, Certification, Registration

• N/A

  Additional Requirements:

• Demonstrated knowledge of health insurance claims processing required.

• Familiarity with health insurance laws and regulations required.

• Proficiency in the use of basic software and computer skills (i.e. Microsoft Word, Excel, e-mail and Internet navigation) required.

  Preferred Qualifications:

• One (1) year of experience in business process redesign, and change management preferred.

• Experience with Health Connect and KRONOS systems preferred.

• Training and experience in the utilization of Lean methodologies preferred.

• Strong knowledge of Workers Compensation and Subrogation laws preferred.

• Familiarity with claims processing preferred.

• Working knowledge of Medicare regulations and guidelines preferred.

• Bachelors degree in business administration, finance, healthcare administration preferred.

COMPANY: KAISER

TITLE: Supervisor, Patient Financial Services

LOCATION: Hyattsville, Maryland

REQNUMBER: 1271901

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.