Denials Supervisor

Ensemble Health Partners•Work at Home - Ohio - Other, OH

3d•$52,100 - $78,150•Onsite

About The Position

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. This position pays between $52,100.00 - $78,150.00/based on experience The RN/LPN Denial Supervisor is responsible for day-to-day operations related to reviewing of denials and drafting of appeals by the Denials/Audit Nurse Specialists. The Supervisor provides daily operational support to the Nurse Denial Specialists and facilitates communication between teams to ensure appeal processes are performed efficiently and effectively. The Supervisor manages denial workflow throughout the team and participates in activities of Denial Management that will provide an opportunity to identify areas for improvement in workflow and quality of work performed. The Supervisor will participate in Human Resource activities that will both evaluate and enhance the knowledge and skill set of the Denials/Audit Nurses.

Requirements

Legally Required License: Registered Nurse or Licensed Practical Nurse
Job Experience: 1 to 3 years
People Leadership Experience: Less than 3 Years
Education Level: Associates Degree or Equivalent Experience
Preferred Area of Study: Nursing

Nice To Haves

Experience in Hospital Operations, Denial Management, Case Management, Utilization Review, and/or prior clinical experience preferred.

Responsibilities

Reviews daily inventory and makes adjustments to staff assignments in order to focus on areas that will bring the greatest return on claim recovery.
Addresses issues presented by staff and other customers to assist with claim resolution which may include collaboration with superiors, peers, other departments, and payers.
Assists the SMART (Specialized Mentor and RevCycle Trainer) with identifying educational needs and providing resources to new hires and existing staff.
Assists manager with interviewing, hiring and performance management and development of staff; assist with counseling and discipline of employees when necessary, in accordance with department and/or organizational policies; participate in mid-year and yearly evaluations.
Attends payer meetings to lead clinical denial issues; Services as backup support for department, facility and other meetings as needed.