Manager, Denials Management

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

As a member of the CorroHealth’s Denial Management team, the Manager of Denial Management will maintain a high level of client satisfaction by serving as the primary point of contact for denial related activities for assigned clients. The Manager will participate actively in implementation activities and manage the denial delivery process and denial team for the clients utilizing this service

• ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Essential Functions :

Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.

Manages the client service level agreement metrics including denial delivery expectations with turnaround timeframe .

Drives monthly client meetings via phone or in person in order to ensure a proactive feedback loop across the team

Communicates regularly with all key members of the CorroHealth team to meet client needs as well as corporate objectives

Maintain awareness and knowledge of client satisfaction levels

Monitor on-going progress and success of each client utilizing various matrix

Identify and participate in resolution of client problems or issues in a timely manner

Provide periodic status reports to CorroHealth leadership teams regarding client status

Meet with clients (at a minimum) on a monthly basis to review monthly reporting package and discuss any operational issues

Develop and present executive level reporting package on a quarterly basis

Manage a team of 3+ direct reports, including performance reviews, employee development and disciplinary action as necessary

Work with client point(s) of contact in resolution of all coding and charge capture related issues

Work in collaboration with Quality Assurance teams regarding all coding quality issues.

Collaborate with team to improve existing products and services

Collaborate with team to develop new products and services

Assist direct reports with accurate application of diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS

Provide and/or aid direct reports with interpretation of coding guidelines for accurate code assignment

Identify and ensure that direct reports understand the importance of documentation on code assignment and the subsequent reimbursement impact

Align personal conduct with and build a team culture that aligns conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct

Comply with and promote and support direct report’s compliance with all internal policies and procedures

Actively participate in Company provided training and education and ensure that direct reports complete mandatory training and education by established deadlines and are able to properly implement and/or practice the principles taught via the Company’s training and education program

Ensure individual and direct report compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information

Thoughtfully evaluate risk, participate in the development of risk mitigation activities and engage in correcting deficiencies

Knowledge, Skills & Abilities:

Bachelor’s degree or the equivalent experience preferred

National coding certification through AAPC or AHIMA

A minimum of 3 years previous coding experience including facility level of service and Professional E/M coding; experience with facility trauma and observation charge capture preferred

A minimum of 2 years of previous management experience in a healthcare setting

Strong verbal and written communication skills Ability to prioritize workload, to meet deadlines and to maintain a high level of quality and accuracy

Initiative, resourcefulness, and attention to detail

Proficient in Microsoft Office applications including PowerPoint, Word and Excel

Ability to navigate in a variety of EMR environments and review hand-written charts

Ability to manage multiple complex projects on an on-going basis is required

Ability to work with various personnel with varying skill sets in team-centered environment

Ability to identify the nature of problems and use high-level problem-solving skills

TRAVEL: Estimated to be 25%-30%, must live within 90 miles of a major airport.

Physical Requirements and Demands:

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.

Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required . At times, incumbents are subject to sitting for prolonged periods. Infrequently, incumbent must be able to lift and move material weighing up to 20 lbs. Incumbent may experience elevated levels of stress during periods of increased activity and with work entailing multiple

• PHYSICAL DEMANDS:
• Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
• A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.