Supervisor Denial Management

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. 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.

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