Position Summary
Primarily responsible for leadership and management of the daily workflow of the assigned denial prevention clients and staff.
Duties and Responsibilities
- Interview, hire, train, audit and review team members
- Lead, supervise, motivate and monitor team members to ensure compliance with Revecore 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 Revecore 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 Revecore management team, and other internal and external clients
- Maintain regular contact with necessary parties regarding claims status including carriers, clients, managers and other Revecore 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
Skills and Experience
- Minimum of 5-years denials claims experience 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 Job Description
- 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
Physical Demands and Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to handle or feel objects, tools or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
- Work Environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time. The noise level in the work environment is usually moderate.
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