Claims Integrity Supervisor

Our client is an $80 million plus growing powerhouse in the cancer treatment realm. They are seeking a full time salaried Claims Integrity Supervisor due to amazing growth.

This position offers a unique opportunity to contribute to a mission driven organization dedicated to providing exceptional patient care.We offer :

• Industry leading vacation / sick time PTO offering work / life balance
• 401(k) with matching
• Medical , Dental, and Vision insurance w / low EE co pays.
• Flexible spending and Health Savings Accounts available.

Role Overview :

The Claims Integrity Supervisor will oversee and mentor 13+ employees within the 39 member team, split into East and West regions.

A significant portion of this role involves understanding the revenue cycle from initial patient encounter, billing, insurance reimbursement, to final payouts.

Primary Responsibilities :

1. Team Management and Development :

• Finding coverage or aiding staff in their workload.
• Evaluating team performance through individual audits and providing feedback to the Senior Claims Integrity Manager.
• Working with the Lead Team Trainer to ensure staff development and training based on audit findings.
• Leading the team to meet individual and team goals.
• Resolving employee issues and disputes with professionalism.
• Providing coaching, identifying areas of improvement, and formulating solution recommendations.
• Keeping staff informed of new or updated standards, systems, procedures, forms, and manuals through meetings and communications.

2. Operational Oversight :

• Handling practice concerns related to outstanding accounts receivable
• Assisting the department manager in overseeing offsite staff, reviewing patient accounts, and making patient calls when needed.
• Coordinating staff schedules and approving time card submissions.
• Monitoring and maintaining the new hire onboarding process.
• Ensuring tasks are completed correctly and timely.
• Addressing real time issues and barriers, providing feedback to the manager.

3. Claims and Appeals Management :

• Ensuring the claims and appeals teams meet department metrics, quality, and productivity goals.
• Collaborating with training teams to provide comprehensive staff training.
• Identifying areas where operational efficiencies can be improved and suggesting alternative methods and procedures.

4. Auditing and Payer Issue Resolution :

• Reviewing work, suggesting actions or training needs, and auditing accounts receivable.
• Assisting with denials and teaching reps how to handle them.
• Coordinating practice calls, follow up calls, and helping reps understand payer cycles and changes in insurance payment patterns.
• Educating patients on coverage in coordination with patient techs, providers, and insurance companies.

Key Skills and Attributes :

• Strong knowledge and familiarity with the revenue cycle and insurance payers.
• Strong understanding of CPT and ICD 10 codes and documentation.
• Excellent communication, team building, and organizational skills.
• Active listening and time management skills.
• Problem solving skills and ability to remain calm under pressure.
• Servant leadership mindset with a firm grasp of company policies.
• Strong work ethic, professionalism, and a positive attitude.

Qualifications :

• At least 5 years of experience with 3 years in a supervisory role.
• Associate degree in health information technology, finance, or a similar field, OR 3+ years of revenue cycle billing experience.
• Experience with multiple EMR, PM, and insurance portals Electronic Health Records (EHR) system.
• A background in a mid to large dermatology, chiropractic, or orthopedic practice with multi location experience is ideal

Preferred Designations :

• RHIT (Registered Health Information Technician)
• AAPC certifications such as CPC (Certified Professional Coder) and / or CPB (Certified Professional Biller)
30+ days ago