Supervisor, Claims

The Supervisor, Revenue Cycle, is responsible for the day-to-day activities related to revenue cycle operations with the goal of meeting all revenue cycle targets and objectives. The ideal candidate should have strong leadership experience and knowledge of pharmacy revenue cycle including home infusion, medical billing practices, and payer reimbursement guidelines, as well as strong communication and problem-solving skills.

Responsibilities

• Assumes responsibility for directing all day-to-day activities related to revenue cycle.
• Provides leadership and direction to revenue cycle staff to meet or exceed business objectives.
• Analyze and trend claims related data to identify inefficiencies and implement process improvement.
• Lead work groups with the ability to identify problems and propose systematic solutions and develop/maintain necessary work plans.
• Maintain designated standards established for handling incoming work.
• Maintains compliance accountability specific to claims administrations in accordance with applicable state and federal laws.
• Supervises and directs staff, supporting professional growth by providing education, training, and appropriate resources.
• Provide leadership and direction through developing and updating policy and procedures, programs, determining appropriate standards and procedures, determining staffing requirements, and training opportunities.
• Recruit and discharge employees when necessary.

Skills & Abilities

• Knowledge of Specialty/Home Infusion software
• Knowledge of pharmacy revenue cycle workflows
• Medical terminology, ICD-10, and HCPCS coding required
• Must have strengths in methods and techniques of business process automation
• Proficient knowledge in MS Office and PC skills preferred
• Able to demonstrate excellent organizational, interpersonal, and communication skills.
• Maintain designated production and quality standards required.
• Must have the ability to effectively interact with internal and external customers.
• Ability to react to users' needs in a timely and efficient manner and direct staff with minimal amount of supervision.

Requirements

• Bachelor's Degree preferred or equivalent business experience of two (2) years.
• Two (2) years minimum management experience required.