Denials Management Supervisor (Physician Billing) - Insurance Department

Job Description

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children's Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

As a  Denials Management Supervisor, you will analyze, track, measure, prevent and manage denials working collaboratively across all areas of revenue cycle management. Work with the team to research payment policies and review potential underpayments/overpayments on both facility and professional accounts. This role will work with payers directly to ensure reimbursements are aligned with negotiated contracts.

The Denials Management Supervisor will work closely with the Manager/Director to provide staff oversight/assistance. This position ensures timely and thorough appeal of all non-clinical denials. The Denials Management Supervisor ensures accurate and compliant resolution of all government-mandated audits. Works with leadership to design and implement procedures and systems to optimize efficiency and minimize the need for manual processing of accounts.

Minimum Requirements

Required Education/Course(s)/Training:
 

• Associate degree or higher and/or 5+ years of experience in professional and hospital revenue cycle account receivable management including government payers is required. 
   
• 2+ years in a related lead or supervisory role within professional and hospital centralized healthcare environment.
   
• 3 years of experience in combined/comprehensive contract variance review/analysis.
   

Preferred Education: 
 

• Bachelor's degree in healthcare administration or related field of study
   
• Graduate of a medical billing program
   
• Medical coding experience and/or certification