Client Manager, Denial Management

Med Metrix•Garden City, NY

About The Position

Job Purpose The Client Manager - Denial Management will provide leadership to Denial Management leadership and their teams, including supervision of staff, reviewing of processes, and providing recommendations for improvement of operations. Goal is to meet or exceed Denial Management KPI benchmarks and client specific KPI's. Maintain or exceed team productivity and quality standards. Work with Director to understand and communicate the root cause of denials and provide data to assist the client to implement effective processes to correct actions. In this position, the Manager assists with recruiting, interviewing, and orienting new employees, monitoring and evaluating staff performance, and ensuring all employees have the tools and training for optimal productivity. Duties and Responsibilities Provide management and supervision related to educating and training staff, evaluating staff performance and monitoring productivity Interview, hire, train, evaluate, and develop staff where applicable Develop and maintain quality control programs, including in-depth and individual performance reviews Orient new hires and provide in-services and training, continuing education, and development related to those functional areas of responsibility Plan, organize and direct overall operations of the Denial Management team assigned as it relates to appeals and follow up Work in conjunction with Director, Client Management, to set and manage target performance levels Actively engage with client(s) to understand needs and deliverables with the goal of creating a true partnership Ensure that team stays current with client requirements and industry requirements and/or trends Maintain an overall objective of high overturn rates, minimization of inventory and accurate client reporting Actively engage with and manage Denial Management team, including routine productivity and quality reviews Assure that team is meeting follow up quality and productivity standards Identify denial trends, including overturn rates, and make recommendations Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Requirements

Bachelor's degree or equivalent combination of education and experience
3+ years' experience managing and leading at a supervisory level or the equivalent
Ability to work well individually and in a team environment
Must be reliable, responsible, goal oriented and flexible
Results driven
Excellent interpersonal, communication and organizational skills
High degree of integrity including ability to successfully deal with sensitive or confidential information
Ability to exhibit poise, composure and confidence when confronting stressful or high¬ pressure situations
Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.

Responsibilities

Provide management and supervision related to educating and training staff, evaluating staff performance and monitoring productivity
Interview, hire, train, evaluate, and develop staff where applicable
Develop and maintain quality control programs, including in-depth and individual performance reviews
Orient new hires and provide in-services and training, continuing education, and development related to those functional areas of responsibility
Plan, organize and direct overall operations of the Denial Management team assigned as it relates to appeals and follow up
Work in conjunction with Director, Client Management, to set and manage target performance levels
Actively engage with client(s) to understand needs and deliverables with the goal of creating a true partnership
Ensure that team stays current with client requirements and industry requirements and/or trends
Maintain an overall objective of high overturn rates, minimization of inventory and accurate client reporting
Actively engage with and manage Denial Management team, including routine productivity and quality reviews
Assure that team is meeting follow up quality and productivity standards
Identify denial trends, including overturn rates, and make recommendations
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards