Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX)

Overview

Manages the daily operations of the patient financial services team to ensure accurate and efficient billing and collections. Coordinates with healthcare providers and insurance companies to resolve billing issues and expedite payments. Monitors patient accounts for compliance with financial policies, trains staff on handling inquiries and payment plans, and implements process improvements to optimize revenue cycle management. Requires reviewing financial reports to identify trends and collaborating with other departments to streamline patient registration and insurance verification, all while maintaining strict confidentiality and data protection standards.

Responsibilities

Key Responsibilities

• Manage and oversee all payer denial activities to support low denial rates and optimal reimbursement.
• Direct daily operations of the denial management process and identify opportunities for workflow and process improvements.
• Establish departmental goals, measure process effectiveness and productivity, and identify the need for updated policies and procedures.
• Plan and organize projects aimed at improving billing effectiveness, reimbursement rates, and appeal turnaround times.
• Perform denial trend analysis, including:
• Epic system edits
• Coding validation
• Charge Description Master (CDM) processes impacting reimbursement
• Authorization trends and performance improvement
• Payer-specific denial trends
• Collaborate with the Enterprise Clinical Denial Assistant Manager to educate departments on proper charging, billing, and coding practices to ensure regulatory compliance.
• Partner with Managed Care and Compliance teams to resolve issues involving departments and payers.
• Report to the Enterprise Senior Denial Manager.
• Provide support across the revenue cycle, including:
• Clinical departments
• Patient Financial Services
• Revenue Integrity
• Managed Care
• Lead and support the Clinical Denial team.
  

Qualifications

Required Education

• High School Diploma or GED
  
  

Preferred Education

• Associate’s degree in a healthcare or business-related field
  
  

Necessary Skills

• Demonstrated knowledge of hospital billing and reimbursement processes, including denials and appeals, third-party contracts, insurance protocols, delay tactics, systems, and workflows, as well as federal and state healthcare regulations.
• Ability to take initiative by identifying problems, developing solutions, and implementing process improvements.
• Strong time-management skills with the ability to multitask effectively in a fast-paced environment with tight deadlines.
• Proven leadership abilities, including conflict resolution and excellent customer service skills.
• Exceptional written and verbal communication skills.
• High level of proficiency with computer systems, including Microsoft Office applications (Word, Excel, Outlook, PowerPoint).
  
  

Required Licensure/Certifications

• One of the following certifications is required: CPC, COC, RHIT, RHIA, or CCS
  
  

Preferred Licensure/Certifications

• Not applicable
  
  

Required Experience

• Three (3) to five (5) years of experience, including:
• Minimum of three (3) years of coding, insurance, or denial-related experience
• Minimum of three (3) years of management experience
  

Supervision

• Supervisory Responsibility: Yes
• Number of Employees Supervised: 1–5
  
  

Age of Patients Served

• Not applicable
  
  

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