Supervisor, Revenue Cycle Management

CareDx, Inc. • Brisbane, CA

6h • Hybrid

About The Position

The primary responsibility of the RCM Authorizations Supervisor is to manage a team of specialists who submit and ensure timely, accurate completion of those authorization requests. Denied authorizations may be appealed by the specialists. Supervisors in the Revenue Cycle Management Authorizations team will report to the Manager of their function. Team sizes may vary but are intended to be no greater than 8 full-time employees on a team; teams with more than four employees may have a team lead reporting to the supervisor. This is a full-time position, Monday through Friday, with occasional overtime as needed. Candidates within commuting distance of the Brisbane, California office will need to come to the office on a regular basis; remote candidates will work and collaborate from home.

Requirements

• High school diploma or equivalent.
• Minimum of 3 years of experience in a medical billing or authorization role.
• Understanding of patient protections under HIPAA and proper handling of protected health information (PHI).
• Working knowledge of insurance policies, billing procedures, and claim terminology.
• Excellent communication and people skills.
• Detail-oriented with strong analytical and problem-solving abilities.

Nice To Haves

• Prior experience in a supervisory role is preferred.
• Experience with laboratory billing software, including Telcor, Xifin or Quadax.

Responsibilities

• Lead your team by establishing and documenting best practices, setting goals, training and coaching staff, and ensuring best practices are followed.
• You will be the primary trainer on your team, with support from a team lead, if your team size allows for a team lead.
• Weekly 1:1s with each member of your team are required, as are weekly team meetings.
• Encourage teamwork and build camaraderie within your team through effective listening and facilitation.
• Model professionalism and build relationships in your internal and external interactions.
• Ensure timely, complete work by your team to minimize DSO.
• Manage staff productivity as a leading indicator of goal attainment.
• Establish and implement prioritization methods for staff in work queues.
• You will be expected to audit your team’s work monthly using a scoring system and provide feedback to them.
• Use experience and expertise to improve upon existing processes, technology and system configurations.
• Prioritize work queues to ensure timely work is balanced among teammates to work the most payable accounts.
• Create authorization requests that may include patient medical records to justify medical necessity for CareDx testing.
• Work with clinicians to obtain any missing medical records.
• Determine the ideal method, documentation and pathway for authorization submission based on the patient’s insurance.
• Use payer websites, or portals, laboratory benefit manager (LBM) portals, or fax to submit the authorization requests.
• Follow up on authorization submissions to ensure timely completion
• When authorization requests are denied, submit appeals to challenge payer decisions.
• Identify approval and denial trends and share best practices. Escalate denial trends to CareDx Revenue Cycle Management leaders, Market Access and/or Payer Dispute Resolution.
• Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
• Share opportunities to improve upstream work to prevent denials.
• Work with patients when their assistance is needed in the appeal process.
• Work professionally with Revenue Cycle teammates to be responsive to requests that require your assistance.

Benefits

• Competitive base salary and incentive compensation
• Health and welfare benefits, including a gym reimbursement program
• 401(k) savings plan match
• Employee Stock Purchase Plan
• Pre-tax commuter benefits
• Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees