Supervisor-Specialty Infusion Acct Coordinator (Exempt)

Company: Mercy
Location: Saint Louis
Posted on: January 24, 2025

Job Description:

We're a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its "Top 100 Places to Work."Overview:

• The Specialty Account Supervisor is responsible for assisting in the direct leadership and oversight of all facets of patient account coordination for multiple coworkers at numerous sites.
• This includes insurance and benefit verification, precertification, ensuring medicalnecessity compliance, denials management, financial assistance enrollment, claim submission and collections.In addition to account coordination, the Specialty Account Supervisor is also responsible for assisting with the interviewing and candidate selection processes for new hires, reviewing and approving PTO requests and maintaining the departmental PTO calendar.
• The Specialty Account Supervisor willsupervise the onboarding processes and ongoing training of new and existing staff on policies, protocols, systems, standards, techniquesand communicating clear instructions to the team.
• The Specialty Account Supervisor will also assist with preparing and delivering annual AOS reviews and initialization and delivering of Corrective Action, when appropriate.
• The Specialty Account Supervisor should expect to review documented clinical information and test results in order to determine whether or not the treatment(s) ordered for the patient meets medical necessity criteria outlined in the insurance companys coverage policy and/or in the case of chemotherapy, the regimen is compliant with NCCN guidelines.
• The Specialty Account Supervisor is a resource and content expert to the Specialty Account Coordinator team for assistance confirming all necessary criteria is met for coverage of services rendered in the Department.
• The Specialty Account Supervisor will work closely with leaders from other departments in effort to facilitate communication related to Peer to Peer reviews and for deciding whether treatment can be provided while authorization is Pending at the payor level.
• The Specialty Account Supervisor will assist and instruct the Specialty Account Coordinator team with appeal writing, provide guidance for correcting outpatient infusion claims which have rejected or denied and assisting patients in enrolling inprograms and foundations that they may qualify for, monitoring services rendered,billing assistance programs for the applicable funds and conducting random quality control checks on all aspects of work produced by the team.
• This position requires the ability to contribute to the continued growth of employees to meet departmental needs as well as a thorough understanding of claims procedures and insurance company regulations.
• It requires monitoring of insurance company regulations for changes in pre-certification, documentation, or claims submission requirements. It also requires accuracy, attention to detail and the ability to communicate well with physicians, staff, patients, and insurance companies.
• The Specialty Account Supervisor serves in a leadership capacity for departmental staff and always performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.Qualifications:
  • Minimum Qualifications: Education: Bachelors Degree and/or a combination of some college hours in associated courses along with aminimum of 5 years leadership experience in a related field is required.
  • Experience: A minimum of 5 years related experience required.Other skills & knowledge (skills, knowledge, abilities)
  • Interpersonal, organizational and analytical skills required.
  • Must possess ability towork in stressful situations, meet deadlines and perform daily responsibilities with consistent accuracy.
  • Ability to use logic, good judgmentand be able to rapidly identify and initiate corrective action when problems arise.
  • Must be able to communicate effectively providing goodwritten and oral direction to co-workers.
  • Must be able to work collaboratively with peers, management and reporting co-workers indemanding situations.We Offer Great Benefits:Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period! We're bringing to life a healing ministry through compassionate care.At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.What Makes You a Good Match for Mercy? Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care – that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply. EEO/AA/Minorities/Females/Disabled/Veterans

Keywords: Mercy, O'Fallon , Supervisor-Specialty Infusion Acct Coordinator (Exempt), Other , Saint Louis, Missouri