Why is remote work so nice? Let's try to see!
Apply
Sr. Manager of Claims Operations
Posted 7 days agoViewed
💎 Seniority level: Manager, 4+ years
💸 Salary: 70000.0 - 85000.0 USD per year
🏢 Company: Sandstone Care👥 101-250Mental HealthNursing and Residential CareTherapeuticsMedicalAddiction TreatmentHealth CareYoung Adults
⏳ Experience: 4+ years
Requirements:
- 4+ years of experience in healthcare billings and claims
- 2+ years of experience in leading a team
- Experience working with out of network and other complex claims adjudication
- Must have valid driver's license
- Work closely with all members of treatment team to assure positive working relationships
- Must consistently demonstrate the ability to establish and maintain good public relations with families, referral agencies, and other community resources
- Must have the ability to express ideas clearly, concisely, convincingly, and effectively when addressing an audience
- Consistently exercise good judgment and adequate emotional stability in evaluating situations and making decisions despite the pressures of deadlines or the occurrence of unexpected stressful events
Responsibilities:
- Oversee the entire billing cycle, ensuring claims are processed timely by following established protocols, attention to key detail and ensuring effective prioritization and escalation
- Understand requirements and build relationships with insurance payors to meet needs and optimize timely, friction free payment
- Process insurance claims for private and employer insurance reimbursement
- Process and follow up on payor denials, consulting with the client and/or family as needed
- Utilize data to identify and address root causes of payor denials
- Manage and intervene as needed for complex claim denials
- Manage and hold team accountable to specific performance metrics
- Post payments in a timely manner
- Complete necessary documentation, timely entries into the records, and maintain compliance with overall documentation
- Assist in preparing documents for annual billing audits
- Ensure that all financial records meet audit and compliance standards and help maintain adherence to regulatory and payor requirements
- Recruit team members where possible with Mental Health / Substance Abuse billing & coding experience
- Record attendance in billing software for services performed to submit claims
- Onboard new billing staff and ensuring they receive thorough training on procedures and performance expectation
- Provide ongoing support to the team and help them stay up to date with new billing functions
- Collaborate with other departments, including working closely with Billing Operations, Benefits Verification, and Director of Revenue Operations to reconcile billing reports
- Responsible for providing regular billing reports, including weekly and monthly summaries of billing, accrual, and denial totals to the Director of Revenue Operations and other key stakeholders
- Assist in reconciling billing data with the financial subledger to ensure accuracy
- Participate on committees and in professional meetings and staffing as necessary for the functions of the program
- Provides supportive leadership for community meetings and selected off-campus activities
- Participates in marketing activities
- Play a key role in identifying opportunities to improve efficiency in billing processes
- Make recommendations for streamlining operations and contribute to ongoing improvements to better support the billing team
- Participates in the facility-wide Performance Improvement Program
- Other duties as assigned
Related Articles
Posted 7 months ago
Insights into the evolving landscape of remote work in 2024 reveal the importance of certifications and continuous learning. This article breaks down emerging trends, sought-after certifications, and provides practical solutions for enhancing your employability and expertise. What skills will be essential for remote job seekers, and how can you navigate this dynamic market to secure your dream role?
Posted 8 months ago
Explore the challenges and strategies of maintaining work-life balance while working remotely. Learn about unique aspects of remote work, associated challenges, historical context, and effective strategies to separate work and personal life.
Posted 8 months ago
Google is gearing up to expand its remote job listings, promising more opportunities across various departments and regions. Find out how this move can benefit job seekers and impact the market.
Posted 8 months ago
Learn about the importance of pre-onboarding preparation for remote employees, including checklist creation, documentation, tools and equipment setup, communication plans, and feedback strategies. Discover how proactive pre-onboarding can enhance job performance, increase retention rates, and foster a sense of belonging from day one.