Health Care Data Quality Supervisor
CurrentPerforms difficult skilled administrative support and technical work supervising Managed Care Authorization Specialist and Health Care Data Specialists to ensure accuracy of client level data in the pre-billing processes in the Agency EHR including researching and identify errors in client level data which impacts billing, maintaining payor contracts and processing pre-authorizations, designing, implementing and monitoring tracking procedures/processes for prior authorizations, collaborating with Reimbursement, IT and Clinical providers for the purpose of ongoing system development, and related work as apparent or assigned. Work is performed under the limited supervision of the Director of Quality and Standards. Supervision is exercised over assigned staff.-Maintains payor contracts to include benefit type tables, group plan tables, payor code rules, and rate class.-Monitors client date errors communicated in a timely fashion and errors resolved in a timely manner-Assists in research and error resolution of service recordings that do not process though automation manager-Monitors and assists in processing service recordings to self pay to close out monthly billing-Processes pre- and reauthorizations for RBHA clients requiring authorizations using Agency EHR.-Collaborates with RBHA staff, medical records, KePro and external customers.-Maintains, gathers and reports data as requested by DMAS, HMO and Authority staff.-Develops accurate database for DMAS/HMO recipients.-Assists with review/revision of RBHA policy and procedures manuals.-Serves as back-up to supervisor.-Provide training to clinical staff on authorization requirements.
