Supervisor, HCS Reclamation Operations (Medicare & Medicaid Focus)
About The Position
The Supervisor, HCS Reclamation Operations oversees and supports daily business operations for Performant's Post-Payment Reclamation-related solutions. We are looking for a candidate with a strong knowledge of Medical claims billing and recovery. Must have a vast knowledge in Medicare regulations, Medical terminology, medical coding, forms UB04 and CMS 1500. This role will require the ability to gather and interpret explanation of benefits (EOB) and Provider feedback to answer questions and assist recovery teams with Provider and Network communications. They will leverage their knowledge in Medical and Rx billing and recovery, with a focus on Medicaid and Medicare rules and regulations; paired with leadership experience and adaptability to support team functions to make a positive impact in the growth of our overall recovery operations. They will play a key support role in continual improvement of recovery processes, procedures, and staff development.
Requirements
- Working knowledge of Medicaid Third-Party Liability (TPL) business, recovery, and revenue cycle management
- Excellent professional written and verbal communication skills
- Proven experience leading and overseeing high performing dynamic teams
- Understands and adheres to HIPAA standards and regulations
- Strong critical thinking, analytical and problem-solving skills
- Self-motivated and thrives in a fast-paced business performing multiple tasks cohesively, with keen attention to detail
- Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs; and consistently performs job responsibilities
- Perform other duties as may be required to meet business needs
- High School Diploma or GED required
- 3 + years of Revenue cycle or Recovery experience.
- 3+ years in a Healthcare claims or revenue cycle management environment.
- 2+ years supervisory experience in fast paced production or call center environment.
Nice To Haves
- BA or equivalent combination of education and experience
- Some college or training in medical terminology, billing, coding, or Medical billing/Coding certificate.
- Extensive experience with provider outreach and communication.
Responsibilities
- Monitoring staff and daily recovery efforts
- Effectively collaborates with Management and teams to ensure departmental needs are met.
- Communicates with team to ensure all production goals are clear
- Leverages strong communication skills, both verbal and written, to assist recovery staff with escalated Provider and Network communications.
- Provides insight and collaborates to ensure appropriate staffing levels and staff competencies for assigned business
- Contributes to continual improvement of reclamation processes, procedures, and staff development
- Supports the organization in meetings with the clients and other reclamation business constituents as needed
- Assist with implementation of new accounts as needed
- Uses excellent communication skills to influence a wide range of internal and external audiences.
- Assists in development and revision of team training materials.
- Advises Leadership of operational training gaps, staff development issues and other observation and areas or opportunities that may involve training.
- Assist in operational training for staff to support operational quality and compliance, and optimal service delivery to clients as needed
- Leads by example and adheres to all Company policies and procedures in performance of job duties and all interactions
- Performs other duties as assigned.
Benefits
- Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
