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Recovery Audit Supervisor
1 month ago
Summary:
Leading the team of Recovery Audit Specialist is responsible for the recovery of over payments made to healthcare providers on claims processed by Third Party Administrators (TPA) for self-funded employers. This requires a collaborative, assertive, persistent approach while overcoming obstacles for payment of the overpayment. This role owns the process and manages cases with efficiency and exceptional time management.
Position responsibilities:
- Perform as the expert for contacting healthcare providers to either collect the overdue amount or negotiate a promise to pay plan to collect payments in installments.
- Resolve provider issues when provider disputes an overpayment request.
- Assists with reporting on the status of unpaid accounts and any repayment progress.
- Training development for the team, including new hires.
- Leading the team by answering daily recovery case questions.
- Assist with working on escalated calls.
- Working on recovery cases over 90 days from providers.
- Problem solves with team members and remove barriers to help improve work processes.
- Hold self and team members accountable for knowledge of, and full compliance with, performance standards as listed on all team member job descriptions.
- Provide direct supervision and staff development to assure productivity and quality of job performance in keeping with the goals and objectives of the company and client.
- Trains, monitors, and supervises Recovery Audit Specialist team members.
- Perform production and quality audits.
- Complete performance evaluations in a timely manner.
- Works to create a positive work environment and proper deployment of direct support staff.
- Performs all other duties as assigned.
Qualifications:
- Understands medical terminology and can speak to ICD-10 codes, CPT codes, and HCPCS codes.
- Active Coding Certification - CPC, CCS, CMC a plus.
- Experience in healthcare claims environment.
- Expertise with CMS/Medicare and/or commercial insurance reimbursement/payment policies.
- 2+ years recovery experience with outbound collection calls with at least 1 year of managerial or lead experience.
- Excellent Customer Service skills and interface with Healthcare Providers.
- Demonstrates excellent organization skills with attention to detail.
- Proficient in Microsoft Office, including Microsoft Word, Outlook, and Excel
- Experience in multi-tasking in multiple platforms and software programs, as well as equipment.
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