Thorough knowledge of all AR scenarios and Denials
Expertise in both Federal and Commercial payor mix
Should be capable to interact with US clients and manage escalations.
Should be good in Denial Management Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials Ability to interact positively with team members, peer group and seniors.
Develop an understanding of the workflows, procedures, and specific criteria for each assigned client.
Identifies operational priorities and other workflow issues; ensures a constant flow of work so that delivery schedules are met.
Ensure that schedules are met and communicates with the leadership team if situations occur that hinder meeting deadlines.
If there is system issues or other emergencies delay in Associates, implements measures/schedules to return to established Associates schedules at the earliest possible time.
Emphasize on productivity goals and takes action to ensure effective and efficient use of staff is maintained. Creatively plan for allocation of extra capacity for backlog Associates.
Assists in coordinating scheduled quality meetings with the production staff.
Active involvement in project launch sessions to understand the Associates process and track the daily progress during the launch
Demonstrated ability to exceed performance targets.
Ability to effectively prioritize individual and team responsibilities and communicates well in front of groups, both large and small
Identify opportunities for Automation in the process and work with IT team for implementation.
Excellent interpersonal skills
Good analytical skills and proficiency with MS Word, Excel, and PowerPoint
Good communication Skills (both written & verbal) Skill Set
What You Will Need :
Must have bachelor s or master s Degree.
10+ Years of Experience in the Health Care industry
Must have experience in managing and mentoring large teams for at least 3+ years.
Good communication skills, both verbal and written.
What Would Be Nice to Have :
Strong attention to detail and a highly reliable work ethic.