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.