Remote Medical Denials Manager - #255791

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Job Summary

Responsible for managing appeals and denials staff in processing accounts and working with designated payors to ensure proper reimbursement, maximize cash flow, and reduce aging accounts receivable.

Essential Functions

• Ensures compliance with state and federal laws and regulations.
• Maintains a thorough understanding of health insurance and government programs, where necessary.
• Maintains understanding of contracts and works with corporate on contractual issues as needed.
• Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution and, in identifying trends of denials seen to prevent ongoing losses.
• Monitors collection of appealed accounts to maintain timely collections of cash.
• Works with all other department managers to identify department training needs for system education, industry updates and changes in collection processes and protocols.
• Works with Director and staff to ensure that employee productivity and quality meets standards.
• Manages workflow, employee productivity, and collection efforts for assigned team.
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Qualifications

• H.S. Diploma or GED required
• Bachelor's Degree required
• Master's Degree preferred
• 3-6 years Previous experience or training in healthcare business office policies, practices and procedures required
• 3-6 years Related experience in denials and appeals required
• 2-4 years Supervisory experience required
  
  

Knowledge, Skills And Abilities

• To perform this job successfully, an individual should be proficient in and/or able to easily learn multiple software programs, including Word, Excel, and Google suite.
  
  

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.