Supervisor, Claim Denials

JOB SUMMARY:

The Supervisor, Claim Denials supervises a team dedicated to executing verification of patient eligibility, insurance confirmation, and insurance discovery. This role drives consistency & accuracy of third-party payor billing information and improves the process of claims processing.

PRIMARY RESPONSIBILITIES:

• Supervise team including monitoring production and quality to specified goals.

• Assists with feedback for hiring, discipline and performance evaluations.

• Oversees the process of providing coverage for production environment.

• Provides department orientation for all direct reports and coordinates training per job description.

• Ensures that on-going training is provided for established employees, including the development & maintenance of standard operating procedures.

• Liaisons with internal departments to promote ongoing communication and ensure accuracy.

• Acts as an escalated level of response for concerns and complaints. 

• Assists staff with enforcing policy.

• Works with cross functionally to manage the entire process from insurance verification to final collection.

• Monitors and validates adherence to policies and procedures, auditing as necessary.

• Completes projects and reports in a timely fashion on a daily, weekly or monthly basis per the direction of management.

• Develops, monitors, coaches, and manages staff, ensuring the development of employees through orientation, training establishing objectives, communication of rules, constructive discipline.

• Promotes a positive working environment through role modeling, team development, respect, and being fair and consistent.

• This role may have occasional access to PCI and PHI both in paper and electronic form and could have occasional access to various technologies to access PCI and PHI (paper and electronic) in order to perform the job.

SKILLS AND QUALIFICATIONS:

• Bachelor’s Degree or equivalent work experience may be used in lieu of the degree.
• 3-5 years of relevant work experience in a leadership role equivalent to lead or supervisor, preferably in healthcare billing environment.
• Knowledge of all Revenue Cycle Management functions, including, but limited to Data Entry, ICD9 Coding, Accounts Receivable Management, and Remittance Application. 
• Proficient in 10 key and alpha/numeric data entry. 
• Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, or Google applications (Gmail, Sheets, Docs and Slides) and general working knowledge of Internet for business use. 
• Ability to work in a fast-past, deadline driven environment. 
• Demonstrated leadership and interpersonal skills. 
• Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement. 
• Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results. 
• Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team. 
• Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.