27 days old

Supervisor, Healthcare Recovery Outreach (MSP) - Internal Candidates Only

Performant Financial
Sunrise, FL
  • Job Code
    2020-50-6-010
Performant Financial Corporation
Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

Supervisor, Healthcare Recovery Outreach (MSP) - Internal Candidates Only
Job Code:2020-50-6-010
Location:Sunrise, FL
Status:Regular Full Time
  
Responsibilities:
INTERNAL CANDIDATES ONLY
POSITION IS REMOTE AT THIS TIME DUE TO COVID-19

As the Healthcare Billing Recovery Operations Supervisor you will be responsible for a team of Outreach Specialists (caseworkers) working with the MSP CRC Debtor stakeholder community to address their high priority questions and concerns regarding CRC Demands and related MSP correspondence.  In addition, the Outreach team provides education and feedback to this MSP stakeholder community to help them understand the full scope of the CRC’s responsibilities and operating processes, and their corresponding responsibilities to ensure that MSP debts are paid timely and accurately.   

•Provides guidance and leads a team answering questions and providing education regarding MSP policy to the GHP/NGHP community.
•Ensure staffing and training of team members for assigned business. 
•Contribute to development and continuous improvement of operational tools, processes and procedures for Outreach.
•Contribute to identification and documentation of casework operations change recommendations identified by the Outreach team.
•Ensure team consistently achieves established objectives, quality, and compliance requirements.
•Leads by example and demonstrates Performant core values in performance of job duties and all interactions.
•Provides feedback, coaching and additional training to assigned team to correct areas of deficiency, as well as performance feedback and skills development to increase capability and effectiveness of specialists.
•Oversee team activities and provide guidance to ensure team actions and documentation on cases are performed in accordance with applicable policies procedures. Perform case actions as required.
•Contribute to documentation of caseworker processing errors identified by the Outreach team.
•Assists in resolution of escalated MSP cases and escalates accounts for Nurse Case Worker review as appropriate for complex claims.
•Support internal groups or functions with interpretation of EOB (explanation of benefits), as well as development of knowledge base and understanding of key concepts and terminology in healthcare billing and claims.
•Ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations.
•May be required to work some Performant holidays due to client requirement.
•Telework or work from assigned office as may be required based upon business needs in adherence with Company policies and requirements. 
•Upon hire (and process facilitated by the Company through the client) obtain and maintain required government client clearances. 

Other Duties
•Performs other duties as assigned.
 
Required Skills and Knowledge:
•Demonstrated ability to lead and ensure operational results in similar healthcare billing recovery or insurance claim review function.  
•Demonstrated ability to resolve and provide guidance in resolving escalated MSP cases. 
•Demonstrated understanding, skills and success in the Outreach function providing answers and education to GHP/NGHP community.
•Demonstrated ability to develop approaches and initiates action to improve and grow employee skills and team results.
•Demonstrated ability to inspire and lead a team of operational staff; knowledge of best practices to successfully hire, train, coach, motivate, develop, manage performance and hold accountability of team members.
•Knowledge and experience with medical claim billing procedures, medical terminology and medical coding, preferably in a role generating, auditing, recovery and/or researching the same involving Worker’s Compensation, Auto Liability and other non-group health plan primary payer liabilities.
•Experience with Coordination of Benefits and Medicare Secondary Payer involving Group Health Plan (GHP) and Non-Group Health Plan (NGHP) Third Parties.  
•Proven expertise in gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues, including Medicare and Medicaid claims.
•Demonstrated ability to provide support and guidance to team members in answering questions and concerns from NGHP and GHP community.
•Ability to communicate professionally and effectively with management, staff, client and vendor representatives, providers, carriers, beneficiaries and other audiences regarding claims and billing payment. 
•Protects patients’ privacy, understands and adheres to HIPAA standards and regulations. 
•Remarkable interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service and servant leadership attitude.
•Ability to share knowledge and educate staff and third parties on healthcare billing and claims related terminology, procedures, and related information.
•Self-motivated and thrives in a fast-paced office environment performing multiple tasks cohesively, with keen attention to detail.
•Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset.
•Ability to apply knowledge learned in training from various forms (memos, classroom training, on-line training, meetings, discussions, etc.).
•Ability to follow, teach, and support improvement of process, procedures and workflow.
•Ability to effectively perform deliver results, and work cooperatively with others to promote a positive team environment.
•Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs.
•Ability to consistently perform job responsibilities.
•Possess a personality type that is ethical, friendly, hard-working and proactive.
•Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.


Physical Requirements:
•Performs duties in a busy standard office environment with moderate noise level or may work remotely from home-office as may be required based upon business needs, in accordance with company policies & procedures.
•Sits or stands at a desk during scheduled shift, reaching as needed to use office equipment.
•Makes and returns calls using an office phone system.
•Views a computer monitor, types on a keyboard and uses a mouse.
•Reads and comprehends information in electronic (computer) or paper form (written/printed).
•Types frequently, but not constantly, using a keyboard and mouse.
•Occasionally lifts/carries/pushes/pulls up to 10 pounds.
 
Education and Experience:
High School diploma or GED required
•Some college in medical terminology, billing, coding or Medical Billing/Coding certification preferred.
 

•Minimum 2 years of experience as a supervisor, or lead with supervisory responsibilities, for similar function. 
•Minimum 5 years of experience in medical billing experience demonstrating depth of knowledge and capability required for the position. 
•Minimum 3 years of experience in customer service, billing reclamation or recovery, or call center role demonstrating application of similar skills preferably in a healthcare or related industry.
•Relevant experience to Outreach with applicable community interaction.
 

Other Requirements:
•Must submit to and pass background check. 
•Must be able to pass a criminal background checks; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment lists.
•Must submit to and pass drug screen.
•Performant is a government contractor. Certain client assignments for this position may require additional background and/or clearances.
 

Job Profile is subject to change at any time.


Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
  

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Posted: 2020-06-11 Expires: 2020-07-10

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Supervisor, Healthcare Recovery Outreach (MSP) - Internal Candidates Only

Performant Financial
Sunrise, FL

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