Appeals Supervisor

Essentials Duties and Responsibilities

• Reviews weekly ETM PIT Reports to ensure worklists are being processed and maintained per department standards
• Sets up and maintains worklists for assigned staff
• Ensures all invoices by reporting category and division are being assigned properly
• Reports to A/R Manager on the status of workload for department
• Maintains department within budget guidelines
• Processes RAC Audit requests
• Reviews assigned edits listed on the Unbilled Charges Report
• Recruits, hires, trains, leads, and motivates staff
• Completes employee performance reviews
• Maintains current and up-to-date technical competence in physician fee-for-service and managed care billing and insurance reimbursement
• Manages staff and procedures ensuring systems operate efficiently and effective personnel relations are maintained
• Disseminates timely billing communications to staff
• Informs appropriate supervisors when obvious inappropriate business practices are evident, which may affect not only reimbursement and accounts receivable management, but also relationships with clients, hospital, and insurance payers
• Completes special projects and reports as requested by the A/R Manager
• Maintains a personal work schedule that allows her/him to be at work regularly and dependably
• Complies with mandatory overtime requirements at the direction of the A/R Manager
• Assumes other duties as assigned by A/R Manager and Assistant Vice President of AR
• Communicates with the AVP and Manager regarding the timely progress of projects and assignments
• Reports on any problems detected, errors, and/or changes to the Manager
• Creates and maintains policies consistent with HCFS and Team Health policies
• Participates in monthly progress meetings with staff regarding Accounts Receivable and system processes

Qualifications / Experience

• Excellent knowledge of healthcare payer reimbursement for physician billing
• Prior experience in managing appeals resolution
• Excellent analytical, communication and interpersonal skills
• Good team management skills
• Good knowledge of ICD-9 and CPT-4 coding
• Excellent follow-up skills
• Excellent organizational skills
• Minimum of (3) three years as a Senior/Lead and preferable five years total physician billing experience with specifically two years’ experience in Denials Resolution or A/R Management
• Set in a high-volume, fast-paced office environment
• Overtime may be required and can be mandated by Management
• Occasional travel to seminar or training sessions may be required

Supervisory Responsibilities

• Manages Appeals Representatives and Senior