1+ months

Supervisor, Healthcare Reclamation Operations "Medicare Focus"

Myrtle Point, OR 97458
Regular Full Time

The Healthcare Reclamation Operations Supervisor oversees and supports daily business operations for Performants Post-Payment Reclamation-related solutions.  We are looking for a candidate with a strong knowledge of Medical claims billing and recovery. Must have a vast knowledge in Medicare regulations, Medical terminology, medical coding, forms UB04 and CMS 1500.  This role will require the ability to gather and interpret explanation of benefits (EOB) and Provider feedback to answer questions and assist recovery teams with Provider and Network communications.

They will leverage their knowledge in Medical and Rx billing and recovery, with a focus on Medicare rules and regulations; paired with leadership experience and adaptability to support team functions to make a positive impact in the growth of our overall recovery operations.  
They will play a key support role in continual improvement of recovery processes, procedures, and staff development.

Essential Duties

Monitoring staff and daily recovery efforts

Effectively collaborates with Management and teams to ensure departmental needs are met.

Communicates with team to ensure all production goals are clear

Strong communication skills both verbal and written, to assist recovery staff with escalated Provider and Network communications.

Provides insight and collaborates to ensure appropriate staffing levels and staff competencies for assigned business

Proven experience leading and overseeing high performing dynamic teams

Contributes to continual improvement of reclamation processes, procedures, and staff development

Supports the organization in meetings with the clients and other reclamation business constituents as needed

Assist with implementation of new accounts as needed

Uses excellent communication skills to influence a wide range of internal and external audiences.

Assists in development and revision of team training materials.

Advises Leadership of operational training gaps, staff development issues and other observation and areas or opportunities that may involve training.

Assist in operational training for staff to support operational quality and compliance, and optimal service delivery to clients as needed

Leads by example and adheres to all Company policies and procedures in performance of job duties and all interactions

Performs other duties as assigned.

*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performants policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.


Required Skills and Knowledge:

Working knowledge of Medicare Third-Party Liability (TPL) business, recovery, and revenue cycle management

Excellent professional written and verbal communication skills

Understands and adheres to HIPAA standards and regulations

Strong critical thinking, analytical and problem-solving skills

Self-motivated and thrives in a fast-paced business performing multiple tasks cohesively, with keen attention to detail

Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs; and consistently
performs job responsibilities

Perform other duties as may be required to meet business needs

Additional Requirements:

- Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening.

- Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Physical Requirements:

**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff may be notified and required to work from a Performant office location on an ad-hoc or periodic basis.

*Basic office equipment required to perform remote work is provided by the company. *

- Job is performed in a standard busy office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard, and uses a mouse.

- Reads and comprehends information in electronic (computer) or paper form (written/printed).

- Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.

- Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.

- Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.

- Occasionally lift/carry/push/pull up to 10lbs.

- Travel as required to meet business needs.


Education and Experience:

-  High School Diploma or GED required

-  BA or equivalent combination of education and experience

-  3 + years of Revenue cycle or Recovery experience.

 3+ years in a Healthcare claims or revenue cycle management environment.

-  2+ years supervisory experience in fast paced production or call center environment.

-  Some college or training in medical terminology, billing, coding, or Medical billing/Coding certificate.

-  Extensive experience with provider outreach and communication.


Other Requirements:

- Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and clearances (as applicable).

- Must submit to and pass pre-hire background check, as well as additional checks throughout employment.

- Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.

- Must submit to and pass drug screen pre-employment (and throughout employment).

- Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Employment VISA Sponsorship is not available for this position

Job Profile is subject to change at any time.

Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 


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Posted: 2022-04-29 Expires: 2022-07-31
Analytics, audit, and recovery services for healthcare, government and student loans.

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Supervisor, Healthcare Reclamation Operations "Medicare Focus"

Performant Financial
Myrtle Point, OR 97458

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