Supervisor, Denials Management

Supervisor, Denials Management

Position Summary

The Supervisor is responsible to manage the daily activities of the Denial Management / Payment Compliance Representatives and follow up functions. The Supervisor will be responsible for ensuring timely payment of insurance claims. Develops expertise among team by facilitating ongoing staff training. Establishes, monitors and reports productivity and quality performance standards. Conducts quality audits and root-cause analysis for all payers to determine opportunities for improvement. Arranges and attends payer meetings. Provides data for payer performance score card, maintains problem claim spreadsheets, tracks / trends payer performance and issues, and monitors AR to facilitate cash flow. Maintains and submits outlier report(s). Maintains departmental KPI's at acceptable levels.

Education

Bachelor of Business - Preferred

Experience

3-5 Years Hospital Patient Accounts, Revenue Cycle - Required

1-2 Years Supervisor / Leadership experience - Required

License & Certification

None Required

Core Job Functions

• Assures that staff is trained and maintains clearly defined duties for the Insurance Representatives. Monitors and reviews insurance accounts receivable, tracks and resolves problem accounts, and assists Insurance Representatives when they have difficulties collecting. Reports problems to the Manager, develops and implements appropriate improvements for accounts receivable resolution.
• Ensures staff complete their daily responsibilities in order to achieve the departmental monthly cash goal and maintain insurance accounts receivable greater than 90 day old at or below the departmental goal. Monitors reminder queues for Insurance Representatives to ensure timely and efficient follow up within established days of reminder queue. Monitors correspondence for timely response within established timeframes.
• Develops a training program and keeps it current for Meditech, Cirius, eSolutions, and Auditlogix / Real Alert. Develops a training program and keeps it current for Outlook calendar and e-mail, API / Laborworks, overview of computer drives, the Internet, and the Intranet. Develops training materials and tools, provides initial and review training as needed, and maintains training and test records.
• Monitors productivity and quality assurance while reporting any variances to manager regarding quality of job performance and time delays.

PI7b284882c17b-30511-38593166