UM Supervisor, Insurance Verification Specialist Team in Denver, Colorado at National Jewish Health

Position Summary
This position is a working supervisor role and is responsible for supervision of the Insurance Verification Specialists who obtain authorizations and referrals for all designated services at National Jewish Health and manage telephone communications and tasking with patients, families, and other members of the healthcare team. Expert level knowledge in all plan requirements for each payer for the specialty outpatient and inpatient hospital setting and is accountable for the submission of all authorizations that do not require clinical support in the UM department.

Essential Duties

1. Supervises and develops an effective staff: providing effective communication, leadership, guidance and resources. Determines staff qualifications and competency: recruits, interviews, selects, hires, trains, orients, mentors, evaluates, coaches, counsels, and disciplines, and rewards. Establishes and monitors staff safety and regulatory compliance.
2. Acts as the daily supervisor for the team under the direction from the Manager. Partners with the department Manager to develop and provide training to staff, conduct annual competency and skills reviews. In addition, is responsible for identifying efficiency options, addresses problems and implements solutions as needed.
3. Educates the Insurance Verification team regarding patient insurance requirements and limitations.
4. Educates the insurance verification team on appropriate communications with patients, families and other members of the healthcare team in regard to the Lung Line Intake process
5. Serves as point of contact for authorizations and authorization related non-clinical questions for local patients.
6. Maintains knowledge of all current procedural and diagnosis codes while utilizing provided resources to obtain new codes as payers change and coding requirements are updated.
7. Reviews, prioritizes and completes authorizations and referral requests. Manages tight deadlines and maintains constant communication with clinic to ensure timely approval of services and avoid missed authorizations.
8. Maintains a thorough understanding of all major insurance plans as well as special requirements for the elective outpatient and inpatient hospital setting.
9. Maintains a thorough understanding of medical terminology in order to identify information in the patient’s medical record that supports medical necessity.

Competencies

1. Accountability: Accepts full responsibility for self and contribution as a team member; displays honesty and truthfulness; confronts problems quickly; displays a strong commitment to organizational success and inspires others to commit to goals; demonstrates a commitment to National Jewish Health.
2. Collaboration/Teamwork: Cooperates with others to accomplish common goals; works with employees within and across his/her department to achieve shared goals; treats others with dignity and respect and maintains a friendly demeanor; values the contributions of others.
3. Managing Work and Time/Project Management: Effectively managing one’s time and resources to ensure that work is completed efficiently. Effectively manages project(s) by appropriately focusing attention on the critical few priorities; effectively creates and executes against project timelines based on priorities, resource availability, and other project requirements (i.e., budget); effectively evaluates planned approaches, determines feasibility, and makes adjustments when needed.
4. Talent Management for Leaders: Clearly establish and communicates expectations and accountabilities; monitors and evaluates performance; provides effective feedback and coaching; identifies development needs and helps employees address them to achieve optimal performance.
5. Managing Conflict: Dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people. Addresses conflicts by focusing on the issues at hand to develop effective solutions when disputes or disagreements occur; helps others resolve conflicts by providing impartial mediation when needed.

Supervisory or Managerial Responsibility
Supervises 5-10 employees

Travel
None

Core Values

1. Be available to work as scheduled and report to work on time.
2. Be willing to accept supervision and work well with others.
3. Be well groomed, appropriately for your role and wear ID Badge visibly.
4. Be in compliance with all departmental and institutional policies, the Employee Handbook, Code of Conduct and completes NetLearning by due date annually.
5. Promotes a workplace culture based on mutual respect and merit, where all individuals are treated fairly and provided with equal opportunity to contribute to the mission and goals of the institution.
6. Adheres to safe working practices and at all times follows all institutional and departmental safety policies and procedures.
7. Wears appropriate PPE as outlined by the infection control policies and procedures.
8. Demonstrates compliance with all state, federal and all other regulatory agency requirements.

Minimum Qualifications

1. Education: High school diploma or equivalent required.
2. Work Experience: Three years of insurance verification experience required. One year leading the work of others preferred. Experience with Pharmacy Medication Authorizations preferred.
3. Special Training, Certification or Licensure: None

Salary Range: $58,656.00 - $77,572.56

Benefits
At National Jewish Health, we recognize that our outstanding faculty and staff are the essence of our organization. For every aspect of health care, our employees are our greatest asset. With that in mind, we have designed a valuable, comprehensive benefits package to meet the needs of our employees and their families.

• Comprehensive Medical Coverage: Multiple Cigna health plans for Colorado, regional office and remote employees. Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) available to pair with some plans.
• Paid Time Off: Generous PTO accruals to use for vacation and sick days, and six paid holidays, all compliant with Colorado state sick leave regulations.
• Dental & Vision Plans: Coverage effective the first of the month after hire.
• Retirement Savings: 403(b) plan with employer contributions after two years.
• Wellness Incentives: Earn up to $200 annually for preventive health activities.
• Tuition Reimbursement: Up to $5,250 annually for full-time and part-time employees.
• Child Care Assistance: Childcare Flex Spending Account (FSA) with annual employer contribution.
• Loan Forgiveness: Public Service Loan Forgiveness (PSLF) eligible employer.
• Disability & Life Insurance: Employer-paid plans and optional buy-up choices.
• Voluntary Benefits: Full suite of coverage options such as Accident, Hospital Indemnity and Legal Plan
• Exclusive Discounts: Savings on local services, insurance, and RTD bus passes.