CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
Recovery Supervisor
Location
United States
Posted
12 days ago
Salary
$24 - $36 / hour
Seniority
Mid Level
Job Description
Recovery Supervisor
CERIS
Role Description The Recovery Supervisor is responsible for analysis and monitoring of claims audit data across multiple platforms. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and claims processing. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers. This is a remote position. Qualifications - 5+ years of relevant experience in a medical or insurance field, which required heavy involvement in bill review processing of claims - 2+ years of previous supervisory/management or project management experience a plus - 3+ years of relevant experience or equivalent combination of education and work experience - Associate degree or higher preferred - Demonstrated knowledge of CMS guidelines and ICD-10 coding guidelines as applicable Requirements - Manage team performance by setting and communicating standards and deadlines, measuring results, and providing feedback - Maintain positive morale by leading the team through example and accountability with a focus on helping each member achieve their best performance - Assists leadership in obtaining complex information from various financial, clinical and operational systems and data sources - Ability to assist with pricing of claims according to provider contracts - Ability to assist team with problem solving regarding customer complaints, or inquiries, including bill review disputes verbally and in written communication - Identifies, quantifies and monitors account detail or workflow processes for barriers - Makes process improvements or initiates courses of action for problem resolution - Analyzes all forms of Revenue Cycle transactions and provides trend analysis - Produces daily, monthly and annual evaluative and statistical reports, analyzing drivers of variances from period to period in order to ensure the integrity and accuracy of revenue cycle data - Evaluates integrity of client data including actively participating with and supporting the Product and Account Management teams with trend analysis of payment and data variances - Participates in the panel interviews, prepares new hire documentation, facilitates associate orientation, and participates in the termination process - Independently leads initiatives as assigned by management, coordinating task teams or other forums to deliver results as identified and/or determined by leadership - Ability to review and understand case rates, per diems, percentage of discounts, and provide detailed charges and costs per claim - Handles escalated requests from client and/or executive leadership - Ensure strict confidentiality of all medical records, PHI, and PII - Additional duties as assigned Benefits - Comprehensive benefits package available for full-time regular employees - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K and ROTH 401K - Paid time off Pay Range CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. Pay Range: $24.30 - $36.30 per hour
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