[Hiring] Manager, Denials Management @CorroHealth

Role Description

As a member of the CorroHealth’s Denial Management team, the Manager of Denial Management will maintain a high level of client satisfaction by serving as the primary point of contact for denial related activities for assigned clients. The Manager will participate actively in implementation activities and manage the denial delivery process and denial team for the clients utilizing this service.

Essential Duties and Responsibilities

• Manages the client service level agreement metrics including denial delivery expectations with turnaround timeframe.
• Drives monthly client meetings via phone or in person to ensure a proactive feedback loop across the team.
• Communicates regularly with all key members of the CorroHealth team to meet client needs as well as corporate objectives.
• Maintains awareness and knowledge of client satisfaction levels.
• Monitors ongoing progress and success of each client utilizing various metrics.
• Identifies and participates in resolution of client problems or issues in a timely manner.
• Provides periodic status reports to CorroHealth leadership teams regarding client status.
• Meets with clients (at a minimum) on a monthly basis to review monthly reporting package and discuss any operational issues.
• Develops and presents executive level reporting package on a quarterly basis.
• Manages a team of 3+ direct reports, including performance reviews, employee development, and disciplinary action as necessary.
• Works with client point(s) of contact in resolution of all coding and charge capture related issues.
• Collaborates with Quality Assurance teams regarding all coding quality issues.
• Collaborates with team to improve existing products and services.
• Collaborates with team to develop new products and services.
• Assists direct reports with accurate application of diagnosis and procedure codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS.
• Provides and/or aids direct reports with interpretation of coding guidelines for accurate code assignment.
• Identifies and ensures that direct reports understand the importance of documentation on code assignment and the subsequent reimbursement impact.
• Aligns personal conduct with and builds a team culture that aligns conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct.
• Complies with and promotes and supports direct report’s compliance with all internal policies and procedures.
• Actively participates in Company provided training and education and ensures that direct reports complete mandatory training and education by established deadlines.
• Ensures individual and direct report compliance with all privacy and security rules and regulations and commits to the protection of all Company confidential information, including but not limited to, Personal Health Information.
• Thoughtfully evaluates risk, participates in the development of risk mitigation activities, and engages in correcting deficiencies.

Qualifications

• Bachelor’s degree or the equivalent experience preferred.
• National coding certification through AAPC or AHIMA.
• A minimum of 3 years previous coding experience including facility level of service and Professional E/M coding; experience with facility trauma and observation charge capture preferred.
• A minimum of 2 years of previous management experience in a healthcare setting.
• Strong verbal and written communication skills.
• Ability to prioritize workload, to meet deadlines and to maintain a high level of quality and accuracy.
• Initiative, resourcefulness, and attention to detail.
• Proficient in Microsoft Office applications including PowerPoint, Word, and Excel.
• Ability to navigate in a variety of EMR environments and review hand-written charts.
• Ability to manage multiple complex projects on an ongoing basis is required.
• Ability to work with various personnel with varying skill sets in a team-centered environment.
• Ability to identify the nature of problems and use high-level problem-solving skills.

Travel

• Estimated to be 25%-30%, must live within 90 miles of a major airport.

Physical Requirements and Demands

• Regular eye-hand coordination and manual dexterity is required to operate office equipment.
• The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required.
• At times, incumbents are subject to sitting for prolonged periods.
• Infrequently, incumbent must be able to lift and move material weighing up to 20 lbs.
• Incumbent may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.