拒赔管理主管

Work From HomeWork From Home Work From Home, Indiana 46544
The Supervisor of Denial Management oversees the daily operations of a team responsible for medical claim denial follow-up and underpayments, and all support activities associated with managing claim denials. This position assists management in maintaining the denial management system, workflows and analysis reporting including the collection and interpretation of patterns to quantify denial causes and their financial impact. Responsible to identify trends to reduce future revenue loss. The Supervisor of Denial Management collaborates with other system departments to apprise them of trends and process improvement opportunities, with a focus on preventing future claim denials.

WHO WE ARE

Franciscan Health is a non-profit health care ministry with primary and specialty care physician groups located throughout Indiana. Franciscan is known for our mission of caring. Our values of Respect for Life; Fidelity to Our Mission; Compassionate Concern; Joyful Service; and Christian Stewardship extend to our employees and patients. With 11 hospital ministries, Franciscan Health is one of the largest Catholic health care organizations in the Midwest. Franciscan Health includes over 1,000 employed physicians and advanced practice providers. Franciscan providers enjoy a team approach to care. Of our 260+ locations, many are nationally recognized Centers of Health Care Excellence.

WHAT YOU CAN EXPECT

• Supervise the work of others and manage the performance of individuals through feedback and recommendations.

• Implement process innovations and works closely with Insurance Payers, Revenue Cycle leadership and Department Managers in revenue-producing departments to reduce denials and to improve upon the Revenue Cycle KPIs.

• Participate in people management activities for direct team members such as conducting performance evaluations, disciplinary actions, and interviews.

• Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data.

• Coordinate department efforts with other departments to align interdepartmental functioning, strategic goals, and expectations.

• Develop and monitor a structured, organized workflow to ensure actions carried out consistently and accurately.

• Act as the first point of escalation within the team by acting as a coach and mentor.

• Prepare operational progress or status reports on a regular basis.

• Independently develop effective relationships with patients, hospital departments, and other external parties.

• Coordinate meetings and in-service training with Payor representatives and vendors.

• Develop reports, policies, procedures and training materials for employee training and business improvements.

• Ensure compliance with state and federal billing regulations.

• Review the final documentation for write-offs and adds avoidable write off language.

QUALIFICATIONS

• Required High School Diploma/GED

• 5 years Patient accounting and Denial Management Required

• 2 years Supervisory or leadership experience Preferred

TRAVEL IS REQUIRED:

Up to 20%JOB RANGE:Supervisor Denial Management $58,0528-$75,462.40INCENTIVE:Not ApplicableEQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, .
Originally posted on Himalayas