Supervisor, Denials, Hospital Billing.

Exemption Status:

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities:

1. Oversees all staff in the Denial Resolution Department.
2. Monitors denials workqueues and reports.
3. Analyzes and researches complex or escalated accounts to determine root cause of denials and determine and execute the best approach for timely and accurate resolution.
4. Works with the Analytics department to set and monitor relevant performance metrics. Ensure that all department metrics are met. Maintains productivity information, works with staff to meet objectives, and provides feedback to staff on performance.
5. Monitors department activity and metrics and troubleshoots coverage and/or volume issues. Provides recommendations to the manager for the most efficient utilization of assigned personnel.
6. Ensures accurate reimbursement for outstanding denied receivables.
7. Monitors established productivity standards.
8. Utilizes internal and payor technology and resources to support account resolution activities.
9. Manages relationships with third party payers, hospital departments, and patients to obtain information required for denial resolution.
10. Coordinates the assignment of tasks for the efficient utilization of available resources.
11. Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation.
12. Communicates regularly with staff, including scheduling meetings, relaying work instructions from upper management and sharing important information and updates.
13. Interacts with other departments to problem solve issues.
14. Serves in a lead role when undergoing system upgrades.
15. Maintains relationships with payers and other outside health care professionals.
16. Attends outside seminars as necessary to keep current with payer requirements.
17. Participates and contributes to the department's goals and objectives in a positive and proactive manner.
18. Submits payroll and keeps staff time and attendance records.
19. Assists manager in assuring that assigned employees are provided with appropriate resources, materials and methods.
20. Works with relevant parties to develop policies and procedures for the department.
21. Works with the Training and Quality Assurance department to train all assigned staff appropriately on specific job duties and new processes. Establishes and maintains quality controls.
22. Assesses work queues and projects daily in order to prioritize workload to ensure deadlines and key performance indicators are met.
23. Escalates issues to management when necessary to ensure timely resolution.
24. Works with Analytics department to identify performance improvement training opportunities and/or needed documentation.
25. Performs the monitoring of internal controls in accordance with established daily schedule.
26. Maintains competency in relative operations software applications.
27. Resolves issues escalated by staff and /or assigned vendors.
28. Facilitates and promotes the sharing of knowledge and content throughout departments.
29. Follows all established departmental policies and procedures.
30. Participates in cross training to optimize billing resources.
31. Demonstrates excellent attendance and actively participates in a variety of meetings and training sessions as required.
32. Complies with established environment of care/safety policies and procedures and all health and safety requirements.
33. Maintains and fosters an organized, clean and safe work environment.
34. Contributes to the development and application of process improvements.
35. Maintains a collaborative, team relationship with peers and colleagues in order to effectively contribute to the group's achievement of goals and to help foster a positive work environment.
36. Demonstrates respect for the diversity of patient and employee populations. Supports and encourages diverse points of view, work and lifestyles.
37. Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc.
38. Performs a variety of related duties as assigned by management.
39. Develops and recommends the budgets for the areas managed. Manages activities to assure financial goals are met.

II. Position Qualifications:

License/Certification/Education:

Required:
1. Minimum of a High School diploma
Preferred:
1. Associates or Bachelor degree in accounting or related field
Experience/Skill:

Required:
1. Four to six years of experience in a health care business office Patient Accounting position.
2. Two to four years of experience in a health care billing office in a supervisory role.
3. Ability to work collaboratively and effectively with people.
4. Exceptional communication and interpersonal skills.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.