Patient Service Advisor Mgr

Patient Service Advisor Manager

Reporting to the Senior Director for Operations and Administration and the Director for Specialty Programs, the Patient Service Advisor Manager will be a key resource for students / faculty providers, attending faculty and PSAs in the development of treatment plans that adhere to third party payer coverage and accurately determine patient financial responsibility for non-covered services. As the PSA Manager, this position will be available to provide guidance to the clinical team on procedural compliance with coding and reimbursement requirements, signed treatment plans and payment agreements, registration and required documentation to ensure revenue cycle optimization. This position will also be responsible for maintaining a strong and current knowledge base on regulatory information as it pertains to coverage and eligibility guidelines and be able to explain these concepts and answer the prevailing rules and regulation questions of students, residents, attending faculty, clinic staff and PSAs. A primary function for the PSA Manager is to manage an assigned group of PSA staff and ensure the accuracy of their evaluation of treatment plan coding, assignment of patient financial liability and other work. In addition, the PSA Manager will collaborate closely with the members of the care team on resolving patient issues pertaining to treatment plan or billing related concerns. The PSA Manager role provides essential advisory services to the patient, as well as students, faculty and staff in the teaching clinic, while also ensuring compliance with a wide range of policies and regulations that govern care.

Responsibilities

Maintain critical knowledge base of Medicaid and Medicaid Care eligibility and coverage guidelines as it pertains to dental coverage in CDM. Expert in the rules and regulations affecting coding, reimbursement and documentation as it pertains to the development of treatment plans, private payment agreements and billing. Identify gaps in coverage and eligibility knowledge of students, residents, faculty and PSA and educate accordingly to close those gaps. Provide guidance to clinical care team on issues tied to treatment plans, payment plans, outstanding balances, eligibility and coverage issues and noncovered services. Manage team of PSAs and ensure accuracy of their work. Sign off on high dollar treatment plans and private payment agreements before finalized by PSAs. Fill in gaps to ensure that all treatment plans are completed in a timely fashion. Collaborates with cross-functional teams, including billing, coding, and clinical operations, to ensure the effectiveness of the revenue cycle process. Collaborate closely with Clinical Directors to resolve patient billing issues, particularly those that have been escalated or require Administrative Adjustments and / or Refunds. Initiate steps to evaluate and improve customer satisfaction as appropriate as it relates to customer facing advisory services. Ensure patients and all stakeholders are treated with respect and courtesy. Promote and ensure high productivity and quality of the work of the PSAs. Also promote culture of teamwork, commitment and accountability. Ensure adequate staffing levels of PSAs to meet timely workload requirements at CDM. Responsible for payroll functions and vacation / sick day management of staff. Train, hire, and perform annual performance appraisals for all PSAs. Encourage growth and knowledge base. Responsible for staff mentorship, development and training. Conform to all Article 28, HIPAA, billing compliance and safety policies and guidelines. Ensures that staff meet regulatory requirements as mandated including but not limited to Art. 28 awareness, HIPAA compliance training, and any and all CU, CUMC, and CDM training programs. Liaison between Patient Care Team and Finance Revenue Cycle team. Escalate any issues as appropriate. Advises the Senior Leadership on matters pertinent to revenue optimization. Maintains matrix reporting to Chief Financial Officer for key revenue cycle integration. Registration and Operations Support. Oversee registration proficiency, accountability and adherence to policies to ensure all required information is capture and reduction in denials / delays due to registration errors. Oversee the accurate, complete and timely registration of patients registered by the internal and remote scheduling teams to ensure reduction in insurance denial through timely and accurate registration. Collaborate with Clinical Directors and Call Center Manager to initiate improvements in registration Complete knowledge and understanding of the scheduling and registration uniqueness for the General Dentistry and Post-Doctoral programs Assist the Directors with Daily coverage arrangements Assist the Directors with Payroll / Vacation approvals for the Front Desk Staff Serve as backup support in the absence of the Directors for Operations Training administrative team on Epic registration requirements and ensure they are knowledgeable on the necessary procedures for scheduling and registration. Monitoring trends post-registration for denials to identify areas of improvement needed by front desk staff Performs other duties and responsibilities as assigned.

Minimum Qualifications

Requires a bachelor's degree or equivalent in education and experience, plus a minimum of three years of related experience.

Preferred Qualifications

Axium Dental software experience. EPIC knowledge preferred. Management of staff experience. Knowledge of Dentistry and electronic Dental billing systems. 5 or more years of related work experience. Ability to lead a team to meet complex operational objectives in an academic dental clinic. Coding, Third Party Reimbursement and ability to determine patient responsibility for non-covered services as well as financing options for a proposed treatment plan experience. Strong customer service orientation. Proven ability to provide advisory services as a key member of a patient care team. Strong interpersonal skills and ability to build and maintain relationships. Excellent communications skills, both written and verbal.