Arbitration & Payer Audits Supervisor in REMOTE at TeamHealth

Job Description

JOB DESCRIPTION OVERVIEW:

The Arbitration Strategy & Payer Audits Supervisor (Supervisor) will oversee the work of others in the arbitration strategy department and work collaboratively with our federal and state arbitration teams on analysis, reporting, quality and preparation and modification of documents. This role also requires the validation, evaluating and trending of substantial amounts of data for presentation and requires strong coding background for the review of payer audit findings and appropriate response to the payer. The Supervisor will assume tasks, duties and responsibilities as assigned by the Director of Health Plan Claim Reviews and Audits. The Supervisor will participate in a wide variety of tasks and will be instrumental in motivating the team.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for oversight of the review and modification of documents related to arbitration
• Interact collaboratively with various departments to support activities and workflows.
• Collaborate with leadership to resolve IDR/Arbitration and payer audit issues.
• Have a thorough understanding of Revenue Cycle Management as well as policies, procedures, and processes as needed.
• Flexibility, innovation, and creativity are necessary characteristics of this candidate. Individual is expected to continuously learn and apply new improvement practices.
• Complete special projects and other duties as assigned.
• Develop and organize reports and documents into a format that can easily be evaluated by Leadership.
• Ability to re-prioritizing key tasks and meet with the director to provide updates of findings and outcomes.

Job Requirements

JOB REQUIREMENTS

• Experience in physician healthcare reimbursement.
• Associates to bachelor’s degree desired in the areas of health administration, business administration, finance, or related field. Proven record of accomplishment and High School Diploma will be considered.
• A strong understanding of revenue cycle management is required.
• Strong computer skills including Microsoft Office with a strong proficiency in Excel spread sheets, using formulas, pivot tables, and filters. Solid knowledge of Adobe, Word, Power Point and One Note.
• Ability to create, format and edit documents as required
• Provide quality written responses regarding appeals, inquiries, and negotiations
• Strong organizational, analytical, and critical thinking skills.
• Must be a high energy, initiative-taker who is creative and outgoing.
• Will be expected to have or quickly acquire knowledge and understanding of the following:
• Medical professional fee billing guidelines and compliance
• CPT, HCPCS, ICD-10
• Reimbursement
• Payer edits
• Accounts Receivable
• Ability to work with confidential information, demonstrate HIPAA Compliance.
• Ability to think critically, work independently, take initiative, and work well in a fast-paced, deadline-driven environment.
• Effective communication and presentation skills.
• Ability to work well with others including managers, subordinates, and peers.
• Attitude and appearance that conveys professionalism, confidence, maturity, and competence.
• Resourcefulness, creativity, and strong decision-making
• Honest and ethical business conduct.

SUPERVISORY RESPONSIBILITIES:

• Supervises the arbitration strategy analyst and administrative coordinator. Provides support to federal and state arbitration teams as well as ATS and appeals staff at the billing centers.

PHYSICAL / ENVIRONMENTAL DEMANDS:

• This is a remote position; accommodations can be made for in-office hours each week.
• Designated workspace required
• Prolonged sitting; with prolonged work in a computer/PC
• Moderate stress levels
• Occasional work in evenings and on weekends if required by project deadlines