Supervisor, Denial Management

ECU Health Medical Center•Greenville, NC

2d•$65,520 - $95,501•Hybrid

About The Position

The Denials Management Supervisor will analyze, track, measure, prevent and manage denials by working collaboratively across all areas of revenue cycle management. This role will research payment policies and review potential underpayments/overpayments on both facility and professional accounts. The Supervisor will work directly with payers to ensure reimbursements are aligned with negotiated contracts. This position ensures timely and thorough appeal of all non-clinical denials and accurate and compliant resolution of all government-mandated audits. The Supervisor will also work with leadership to design and implement procedures and systems to optimize efficiency and minimize the need for manual processing of accounts.

Requirements

Associate degree or higher and/or 5+ years of experience in professional and hospital revenue cycle account receivable management including government payers.
2+ years in a related lead or supervisory role within a professional and hospital centralized healthcare environment.
3 years of experience in combined/comprehensive contract variance review/analysis.
Must be able to work independently and efficiently with little supervision.
Strong customer service and human relations abilities.
Ability to effect collaborative alliances and promote teamwork.
Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders.
Ability to make good judgments in demanding situations.
Ability to react to frequent changes in duties and volume of work.
Must have a strong desire to teach / transfer knowledge to team members.
Ability to recognize, evaluate, solve problems, and correct errors.
Show proficiency in building and maintaining strong internal relationships while motivating and inspiring team members through effective consultative skills.

Nice To Haves

Bachelor's degree in healthcare administration or related field of study
Graduate of a medical billing program
Medical coding experience and/or certification
Ability to use various computer applications is preferred including EPIC.

Responsibilities

Analyze, track, measure, prevent and manage denials.
Research payment policies and review potential underpayments/overpayments on both facility and professional accounts.
Work with payers directly to ensure reimbursements are aligned with negotiated contracts.
Provide staff oversight/assistance.
Ensure timely and thorough appeal of all non-clinical denials.
Ensure accurate and compliant resolution of all government-mandated audits.
Design and implement procedures and systems to optimize efficiency and minimize the need for manual processing of accounts.
Identify and implement process improvements to optimize revenue cycle performance.