Psychology Office Supervisor - Good Shepherd Rehabilitation Network

• JOB SUMMARY
  • Provides front-line supervision to all other administrative staff. Maintains the Good Shepherd Psychology Group billing services by posting all charges and payments for the purpose of maintaining a current AR flow. Assures psychologists are credentialed in appropriate insurances to produce revenue.
• ESSENTIAL FUNCTIONS
  • ADMINISTRATIVE SUPERVISION
    • Develops and maintains office administration procedures that directly relate to optimal functioning of the Psychology Group
    • Organizes workflow to be efficient and to maximize services performed to ensure uninterrupted service and revenue flow
    • Coordinates day to day operations
    • Ensures compliance with health insurance regulations, medical laws, high ethical standards
    • Tracks financial performance including impact of changes in insurance reimbursement, patient payer mix
    • Provides training, supervision and support to other administrative staff supporting the Psychology Group (i.e. Secretary)
      • Assures that front office policies and procedures are followed, or modified or changed as needed to accommodate ever-changing insurance regulations and policies, as well as GSR policies and procedures
    • Assists in ensuring patient satisfaction including troubleshooting complaints and improvement to prevent recurrence
  • ASSURES REFERRAL AND AUTHORIZATION OBTAINED
    • Works with Secretary and other department and facility staff to assure proper referral forms or preauthorization is obtained prior to visit
    • Directly communicates with other providers, insurance companies as required to obtain proper referrals and authorizations prior to providing services
  • PREPARES BILLING
    • Attaches appropriate modifiers, ICD9 and CPT codes to patient encounters, montitoring accuracy of charges submitted by psychologists
    • Assures that necessary referral and/or authorization information is attached to all bills prior to submission to payers
    • Keeps up-to-date with coding guidelines and insurance-specific guidelines and procedures, thereby limiting delayed payments, denials and appeals
    • Performs transaction entry into the billing system
    • Processes HCFA and other insurance billing forms and patient statements
    • Reconciles accounts and makes daily deposits
  • REVENUE CYCLE/FINANCIAL PERFORMANCE
    • Requests medical records and other information required for claims, attaching any necessary paperwork to claims
    • Tracks charges from billing to payment to identify and maximize efficiency in receiving payment
    • Directly contacts insurance companies to resolve disputed claims and appeals to maximize revenue.
    • Keeps abreast of billing and payment trends/regulations with regard to behavioral health billing in context of medical setting
    • Acts as liaison between patient and psychologist to address billing questions, concerns and discrepancies
    • Interacts with patients to collect outstanding balances and keep patient portion of accounts current
    • Takes all appropriate steps necessary to appeal denied claims, seek appropriate reimbursement
  • ASSURES PSYCHOLOGISTS ARE CREDENTIALED IN ALL IN-NETWORK INSURANCES
    • Regularly updates list of in-network insurances
    • Submits applications for credentialing as appropriate to maintain insurance participation parity with GSRN to every extent possible
    • Obtains necessary paperwork for credentialing and re-credentialing of psychologists and assists in completion and timely submission, tracking progress in credentialing process
    • Identifies problems with payers related to credentialing and plan participation and acts to resolve issue, including investigation of single-case agreements or other options when necessary
  • TRACKS STATISTICS
    • Runs end of month reports
    • Assists Director by tracking information needed for the Psychology department and Finance department regarding financial and P/L of psychologists and department
  • CONTRIBUTES TO TEAM EFFORT
    • Provides coverage for Secretary, answering phone inquiries and assisting in client patient registration and clerical support as needed
    • Demonstrates flexibility in helping to provide necessary logistical support for Psychology and other facility colleagues, if needed
    • Provides education to others, contributing from own areas of professional expertise
    • Promotes positive work environment
  • PROTECTS PATIENT'S RIGHTS
    • Maintains confidentiality of personal and financial information in accordance with facility policies and legal regulations, including special protections for mental health records
• QUALIFICATIONS:
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    
    • Education
      • High School Diploma required
      • Associate's Degree in Secretarial Services or certification from an accredited medical office program preferred
    • Work Experience
      • 3 - 5 years of experience in medical or behavioral health office administration, including customer service, insurance benefits, authorization and claims processing
      • Previous experience with detailed insurance billing and coding, electronic medical record and revenue cycle
      • Physician office billing experience preferred, with experience in mental/behavioral health billing highly desired
    • Licenses / Certifications
      • N/A

PI254565812