Supervisor-Denial Mitigation/Audits/Correspondence - HS Denial Mitigation Corporate

Summary

The Denials Mitigation Supervisor supervises the daily operations of the Denials Mitigation team as it relates to audits, mail and correspondence to ensure that correspondence is processed in a timely manner and in accordance with BMHCC and/or the payer's policies and procedures. The supervisor has a thorough understanding of Baptist's Revenue and Reimbursement Cycle, payer contractual guidelines, billing procedures, including the billing software system. The supervisor will be responsible for analyzing and interpreting trends associated with correspondence, audits and appeals to effectively manage reimbursement, and build strategies for mitigating future denials. This role will develop training and tools to support the denials and appeals management processes. The supervisor has a clear and functional understanding and the ability to troubleshoot the roles supported.

Responsible for assuring compliance with all local, state and federal regulations.

Incumbent is accountable for these functions 24 hours per day, 7 days per week.

This position is under the general direction of the Manager, Denial Mitigation

Responsibilities

1.Responsible for overall operational supervision of the Denial Mitigation Department as it relates to audits, mail and correspondence.

2.Oversees all activities related to coordination, processing and appeals for medical claim recoupments due to clinical audits.

3.Oversees day-to-day supervision of the denial staff to include training, monitoring of compliance and quality, establishing individual and team performance measures, recruiting, hiring/terminating, conducting performance reviews, and establishing goals.

4.Collaborates with the Manager/Director/Revenue Cycle Team in the resolution of treatment and services recouped by Medicare, Medicaid, Tricare, commercial payers, and Managed Care organizations.

5.Recommends and implements departmental policies, procedures, and methods to increase the overall effectiveness of the denial management program.

6.Coordinates processes for collecting, organizing, analyzing and reporting data to enable leadership and others to make appropriate decisions to improve the denial mitigation process.

7.Works with internal and external customers to identify opportunities for improvement, which result in enhanced denial management services and customer satisfaction.

8.Performs other duties as assigned and directed.

9.Contributes to a positive work climate and the overall team effort of the department.

Requirements, Preferences and Experience

Education

Bachelor's Degree preferred

Experience

3-5 Years Audit or ROI, or HIM Experience preferred

Basic understanding of Revenue Cycle functions, flow, and operations strongly preferred

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:

• Competitive salaries
• Paid vacation/time off
• Continuing education opportunities
• Generous retirement plan
• Health insurance, including dental and vision
• Sick leave
• Service awards
• Free parking
• Short-term disability
• Life insurance
• Health care and dependent care spending accounts
• Education assistance/continuing education
• Employee referral program

Job Summary:
Position: 16228 - Supervisor-Denial Mitigation/Audits/Correspondence
Facility: BMHCC Corporate Office
Department: HS Denial Mitigation Corporate
Category: Finance and Accounting
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area