Performant Healthcare, Inc. · 22 hours ago
Supervisor, Healthcare Billing Recovery Operations (SCA)
United States
Full-time
Remote
Mid, Senior Level
$60K/yr - $70K/yr
5+ years expPerformant Healthcare, Inc. is a leading healthcare intelligence company focused on delivering value and efficiency to health plans. They are seeking a Healthcare Billing Recovery Operations Supervisor who will be responsible for leading a team of case specialists in billing and recovery services, ensuring compliance and quality in operations.
AnalyticsCustomer ServiceFinancial Services
Responsibilities
Ensure staffing and training of case specialists for assigned business
Contribute to development and continuous improvement of operational tools, processes and procedures
Ensure assigned team consistently achieves established metrics and goals assigned, 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 and oversight received from quality reviews and/or management, as well as performance feedback and skills development to increase capability and effectiveness of specialists
Oversee work activities and provide guidance for case and call escalation to specialists including, but not limited to:
Review account claim and other documentation to verify payment liability for claims paid in error
Make outbound calls to contact liable parties regarding payment of claims; answer questions and educate liable parties on their obligation to pay
Effectively follow scripts, guidelines and other tools provided to have professional conversations with liable party contacts
Review documentation and claim billing, build the case file to determine/validate liability, evaluate and respond to defenses refuting payment liability, status the account and initiate appropriate letter correspondence, answer questions and/or provide information that will bring to successful payment or other appropriate account action
Initiate applicable action and documentation based upon payment option, actions required if new information is identified that may change the obligation to pay, or escalation in the event of refusal to pay
Update company systems with clear and accurate information
Initiates activity based upon arrangement with liable parties; follows-up and follows through accordingly to ensure documentation and activity is on-time and accurate in accordance with policies and procedures
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
Perform other incidental and related duties as assigned to meet business needs
Qualification
Required
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
High School diploma or GED required
Preferred
Some college in medical terminology, billing, coding, or Medical Billing/Coding certification preferred
Benefits
Medical
Dental
Vision
HSA/FSA options
Life insurance coverage
401(k) savings plans
Family/parental leave
Paid holidays
Paid time off annually
Company
Performant Healthcare, Inc.
Billions of dollars are lost each year to waste, improper payments and unpaid debts.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
$25MKey Investors
Wells Fargo
2023-11-07Post Ipo Debt· $25M
2012-08-10IPO
Leadership Team
Simeon Kohl
Chief Executive Officer
Rohit R.
Chief Financial Officer
Recent News
2024-11-12
2024-11-06
Company data provided by crunchbase