Lead, Healthcare Denials Management

About the Role

Impact you will make

Do you enjoy leading a team? Would you like lend positive leadership and quality coaching to FinThrive's healthcare insurance reimbursement team?

Join our team and play a vital role in ensuring hospitals receive the reimbursements they deserve. You'll be part of a dynamic team using cutting-edge ARO software to streamline medical claims and collections. As an Lead, you will have the opportunity to quality coach and lead representatives and ensure appropriate solutions to complex scenarios.

As Lead, AR Recovery, you will organize and manage the daily activities for team of AR Denials Specialists and Follow-Up Representatives. The team's primary function is to identify and validate revenue opportunities associated with insurance eligibility and coverage plans. You will be responsible for selecting talent, onboarding, training and growing associates to the next level. You will also be accountable for quality assurance, productivity metrics and the performance management of their team. In this role, you will develop operational expertise and possess the ability to navigate multiple patient accounting applications.

What you will do

• Team quality coaching: review scenarios to provide positive leadership, coaching on alternative actions/outcomes, policy, and follow up step
• Provide development daily through informal observation and formal monitoring. This includes monitoring telephone calls, voice and emails and conducting side-by-sides. Complete and maintain required documentation regarding performance and training/development needs. Review documentation with staff members

• Maintain an adequately trained staff to handle current production goals within department
• Monitor and ensure that the daily production goals and quality of work are being achieved by the staff
• Perform daily and weekly QA audits to ensure accounts are worked in accordance with client work standards and project objectives (e.g., No Activity, Aging, Cash Recovery)
• Perform workflow management of the team as well as making recommendations on enhancements to processes
• Partner with the talent acquisition team to interview and select candidates, assist in successfully onboarding a team of Revenue Cycle Representatives
• Create and deliver appropriate onboarding, training and development to all current and future associates
• Work collaboratively with leadership and other team members to confirm, challenge, or provide trending and solutions
• Serve as liaison between internal team and client staff, when needed, to resolve accounts
• Create client reports and invoices
• Review output of team and determines appropriate assignment of KPI targets
• Meet with each member of the team regularly to provide coaching and continuous feedback
• Proactively address training and skill gaps by creation of and delivery of training
• Understand cross-functional teams and looks for opportunities to enhance and integrate processes
• Integrate experience into team process and performance

What you will bring

• 10+ years of experience in Denials Management, UB-04 Follow-Up and Contract/Reimbursement Analysis, including investigation of both pricing and reimbursement variances and denial management
• 4+ years successfully leading teams in a direct supervisory role
• Medicaid, Medicare, and/or Commercial billing experience
• Detailed understanding of healthcare insurance follow-up processes, including resolving non-paid, denied, under-paid, and rejected claims
• Established understanding of HIT systems like EPIC, Paragon, Cirius, Zirmed or other billing systems
• Coaching and development skills with the ability to organize activities for a productive team and lead effectively with time and project management skills
• Strong problem-solving skills with the ability to research complex information, create insights, communicate recommendations and implement appropriate solutions
• Demonstrated ability to be innovative, coach/lead associate's, proactively address concerns (business and associate), and maintain departmental quality standards
• Ability to work in a team environment, with strong interpersonal, leadership, and negotiation skills
• Knowledge of computers for data processing, spreadsheets, and MS Office
• Excellent verbal and written communication skills
• Demonstrated ability to work in a fast-paced multitasking regulatory, technical, and administrative environment
• Demonstrated ability to maintain confidentiality in all matters relating to the position, including but not limited to performance, development needs, personnel actions, and departmental objectives

What we would like to see

• Bachelor's degree
• Certification in billing or medical coding

Why Join Us?

• Work with an innovative team using advanced ARO technology to improve medical billing efficiency
• Career growth opportunities in healthcare finance and revenue cycle management
• Competitive salary, benefits, and a supportive team culture
• Apply now to make a real impact with FinThrive!