Manager of Insurance Follow-up & Appeals

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    "description": "<p><u><strong>Position Summary</strong></u></p>\r\n\r\n<p>The Manager of Insurance Follow-Up and Appeals reports directly to the Revenue Cycle Director and is responsible for oversight of client accounting functions for insurance clients. &nbsp;The Manager of Insurance Follow-Up and Appeals helps improve cash flow and participates in managing the overall health of the company&rsquo;s receivables.&nbsp;</p>\r\n\r\n<p><strong>Relationships and Contacts</strong></p>\r\n\r\n<p style=\"margin-left:40px;\"><em><strong>Within the organization:</strong></em> Initiates and maintains frequent and close working relationships with staff, and peers throughout the organization.<br />\r\n<em><strong>Outside the organization:&nbsp;</strong></em>Maintains working relationships with community partners, health insurance companies, prospective and current client as well as company vendors.&nbsp;</p>\r\n\r\n<p><u><strong>Position Responsibilities</strong></u></p>\r\n\r\n<p><strong>Essential Responsibilities</strong></p>\r\n\r\n<p>1.&nbsp;&nbsp; &nbsp;Provides leadership, supervision, ongoing feedback and coaching for team members within client accounts reporting alignment.<br />\r\n2.&nbsp;&nbsp; &nbsp;Supports preparation of daily census reporting.<br />\r\n3.&nbsp;&nbsp; &nbsp;Supports month-end processes for assigned facilities and areas of responsibility.<br />\r\n4.&nbsp;&nbsp; &nbsp;Ensure accurate, timely and complete client account follow-up.&nbsp;<br />\r\n5.&nbsp;&nbsp; &nbsp;Ensures adequate staffing coverage is consistently in place, including time off coverage.<br />\r\n6.&nbsp;&nbsp; &nbsp;Confirm accounts are processed to completion to resolution.&nbsp;<br />\r\n7.&nbsp;&nbsp; &nbsp;Documents all activity taken on an account in the client account notes.<br />\r\n8.&nbsp;&nbsp; &nbsp;Effectively identifies and brings forward trends that inhibit timely payment.<br />\r\n9.&nbsp;&nbsp; &nbsp;Confirms claims are processed within the established productivity standards, for timely follow-up maintaining and updating all patient accounts to reflect current information.<br />\r\n10.&nbsp;&nbsp; &nbsp;Reviews accounts for accuracy including account balance, payer plan and financial class, level of care, denials, and insurance requests.<br />\r\n11.&nbsp;&nbsp; &nbsp;Understands and interprets insurance explanation of benefits, knowing when and how to ensure that payment has been received.<br />\r\n12.&nbsp;&nbsp; &nbsp;Responds in a professional and timely manner to all billing-related inquiries from patients, guarantors, staff and payers.<br />\r\n13.&nbsp;&nbsp; &nbsp;Understands authorizations and limits to coverage such as the number of authorizations/units.<br />\r\n14.&nbsp;&nbsp; &nbsp;Documents, analyzes, and trends billing and collection activities and communicates to supervisor as appropriate.<br />\r\n15.&nbsp;&nbsp; &nbsp;Coordinates with facilities and medical records for resolution of disputed/denied claims and monitoring of the appeals and medical record claims.&nbsp;<br />\r\n16.&nbsp;&nbsp; &nbsp;Directly manages the Insurance Collections Supervisor.&nbsp;<br />\r\n17.&nbsp;&nbsp; &nbsp;Trains team members on new and updated processes.</p>\r\n\r\n<p><strong>Additional Responsibilities</strong></p>\r\n\r\n<p>1.&nbsp; &nbsp; Provide support on special or large analysis projects, as assigned.<br />\r\n2.&nbsp;&nbsp; &nbsp;Performs other duties, as assigned.&nbsp;</p>\r\n",
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Equal employment opportunities apply to all terms and conditions of employment. Odyssey reserves the rights to modify, interpret, or apply this job description in any way the organization desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise. 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