Denials Prevention Supervisor - Hospital Revenue Cycle


Cincinnati, OH

Industry: Healthcare


5 - 7 years

Posted 164 days ago

This job is no longer available.

We are seeking someone with hospital revenue cycle experience, experienceworking with denials and strong leadership skills.


Position Title     Denials Prevention Supervisor ? Hospital Revenue Cycle


Relocation       No


Location         Cincinnati Area


Position Summary: Primarily responsible for leadership and management of the daily workflow of the Denial Prevention team.


General Purpose: Leadership; management; employee and client relations; problem solving resolution; critical thinking; auditing; relationship and team building


Essential Duties and Responsibilities:


Interview, hire, train, audit and review team members

Lead, supervise, motivate and monitor team members to ensure compliance with policies, procedures and standards

Advise Manager of any workflow, personnel, client or carrier issues or improvement opportunities both within the department and in other operational departments

Support and assist team members with difficult issues concerning work, co-workers, clients and/or carriers; offer suggestions to assist in process of underpayment reviews and collections

Ensure team successfully achieves quality, productivity and collection goals

Participate in workflow examination or special projects as directed by management

Track various departmental information in order to develop and maintain benchmarks, create goals, manage trends, identify areas of opportunity and weakness, identify issues and training opportunities

Collect, track, and analyze various client-requested data and reports to identify trends, process improvements, and best practice recommendations

Assist in and/or lead presenting and feeding back to the client the results and recommendations during executive summaries and working sessions

Build strong, lasting relationships with the staff, the management team, and other internal and external clients

Maintain regular contact with necessary parties regarding claims status including carriers, clients, managers and other personnel

Organize, prepare and/or attend department, client and company meetings

Investigate various issues with carriers and their contracts; respond to questions and resolve problems

Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting

Perform duties and responsibilities of Project Coordinator, Lead Analyst or Analyst as needed and instructed by the Manager

Attend client, department and company meetings

Comply with federal and state laws, company policies and procedures

Other duties as assigned


Essential Skills and Experience:


Minimum of 5-years denials claimsexperience and/or training

High school diploma or equivalent

Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook

Analytical and problem solving skills

Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division

Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form

Ability to write routine correspondence (in English)

Ability to define problems, collect data, establish facts and draw valid conclusions

Strong customer service orientation

Excellent interpersonal and communication skills

Excellent leadership skills and abilities

Strong team player

Ability to work on own with minimal supervision and use effective time management skills to complete tasks on time

Commitment to company values

Ability to travel by automobile or public transportation to visit or setup work sites


Bottom line requirements:


1. 5+ years of denials claimsexperience or training including hospital revenuecycle claims.

2. High school diploma or equivalent

3. Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook.

4. Strong leadership skills.