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.

EssentialFunctions:

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 primaryaccountabilitieslisted below. Specific tasks,responsibilitiesor competencies may be documented in the incumbent’s performanceobjectivesas outlined by the incumbent’s immediate supervisor or manager.

• Manages the client service levelagreementmetrics including denial delivery expectations with turnaround timeframe.

• Drives monthly client meetings via phone or in personin order toensure a proactive feedback loop across the team

• Communicates regularly with all key members of theCorroHealthteam 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 clientutilizingvarious matrix

• Identifyandparticipatein resolution of client problems or issuesin a timely manner

• Provide periodic status reports toCorroHealthleadership teamsregardingclient status

• Meet with clients (at a minimum)on a monthly basisto 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, employeedevelopmentand 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 teamsregardingall coding quality issues.

• Collaborate with team to improve existing products and services

• Collaborate with team to develop new products and services

• Assistdirect reports withaccurateapplication of diagnosis and procedure codesutilizingICD-10-CM, ICD-10-PCS, CPT®, and HCPCS

• Provide and/or aid direct reports with interpretation of coding guidelines foraccuratecode assignment

• Identifyand ensure that direct reports understand the importance of documentation on code assignment and thesubsequentreimbursement 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 withand promote and support direct report’s compliance with all internal policies and procedures

• Activelyparticipatein Company provided training and education and ensure that direct reports complete mandatory training and education byestablisheddeadlines andare able toproperly 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,participatein the development of risk mitigationactivitiesand 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 yearspreviouscoding 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 ofpreviousmanagement experience in a healthcare setting

• Strong verbal and written communication skills Ability to prioritize workload, to meet deadlines and tomaintaina high levelof quality and accuracy

• Initiative, resourcefulness, and attention to detail

• Proficient in Microsoft Office applications including PowerPoint,Wordand 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 isrequired

• Ability to work with various personnel with varying skill sets in team-centered environment

• Ability toidentifythe nature of problems and use high-level problem-solving skills

TRAVEL:Estimated to be 25%-30%, must live within 90 miles of a majorairport.

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 dexterityisrequiredtooperateoffice equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions isrequired. 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.