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Reimbursement Variance Supervisor
2 months ago
Description
At SCP Health, what you do mattersAs part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: Flexible schedules and work-from-home opportunities Strong track record of providing excellent work/life balance Comprehensive benefits package and competitive compensation Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect. What you’ll be doing: The Reimbursement Variance Supervisor is responsible for managing staff performance and ensuring the reimbursement for contracted and governmental plans is as expected. The Reimbursement Variance Supervisor will strategize techniques for pursuing any payment variances through bulk appeals and identify cost-reduction procedures and ensuring the Contracts Database and Athena reflect the contract terms. This position is responsible for the direct supervision of a team of Reimbursement Variance Auditors with the potential to grow in correlation with business needs. Daily oversight and supervision of the Reimbursement Variance Department Plans, organizes, and directs the work activity of the reimbursement variance auditing team, leading to excellent quality and production results Manage inventory to ensure departmental goals are met Develop processes for each project type based on prior project results and existing Policies and Procedures Analyze identified contracted payer claims issues Determining priority of payment projects Maintain all auditing databases to ensure accurate audits Summarize and report on audit findings in key policies Identify opportunity for contracting and revenue recovery Collaborate with managed care plans regarding resolution of claims projects Collaborate with leadership regarding claims issues and decisions Maintenance of the managed care contract database Performance reviews and evaluation of reimbursement variance auditing team Responsible for overall team development with regard to customer focus, performance improvement/reengineering, process management, motivating others, drive for results, and quality/timely decision making Project oversite for the transition of down codes appeals Manage the down coding build in the system Identify opportunity for appeal cost reduction and atomization Collaborate with MGS client’s request and appeal processing Who/What we are looking for: Bachelor’s degree or equivalent health care work experience 1-2 years’ experience in the health care preferably in billing or appeals & denials Demonstrated ability to make decisions independently Experience in Emergency Medicine billing and/or Healthcare reimbursement Experience in Customer Service – external and internal Familiar with a variety of the field's concepts, practices, and procedures Knowledge of state and federal insurance laws Relies on experience and judgment to plan and accomplish goals To learn more about SCP Health, please visit:
Join our social circle: SCP Health is an Equal Opportunity Employer.
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