Supervisor, Zero Balance Denials

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Lead and manage Zero Balance operations.

• Provide daily supervision, mentoring, and support to designated team members.

• Oversee hiring, onboarding, training, performance management, and corrective actions.

• Prepare and conduct performance evaluations and account assessments.

• Educate and guide staff on accuracy, payer strategies, and zero balance recovery techniques.

• Conduct quality-control reviews to ensure due diligence, compliance, and adherence to workflows.

• Identify and pursue recovery opportunities within large inventories of zero-balance hospital claims.

• Analyze claim payments utilizing proprietary systems, tools, and payer documentation.

• Prepare and submit billing packets and appeal letters.

• Follow up with insurance companies to ensure proper reimbursement.

• Research and gather medical records, implant invoices, and necessary supporting documentation.

• Apply knowledge of CPT, ICD-10, and modifiers to claims, appeals, and recovery strategies.

• Address and escalate access and claim-resolution obstacles.

• Coordinate responses to inquiries and issues reported by external clients.

• Facilitate meetings addressing client concerns, process enhancements, and operational challenges.

• Communicate directly with clients regarding system access, documentation, payment inquiries, and training.

• Collaborate with Managers to prioritize tasks and align with operational objectives.

• Work together with Data Analytics, Data, and Product teams on claim, payment, data import, and calculation matters.

• Support departmental and enterprise operational initiatives.

⛳️ Requirements

• High School Diploma or GED is mandatory; an Associate’s or Bachelor’s Degree is advantageous.

• Over 5 years of experience in healthcare, particularly within the zero balance line of business.

• More than 5 years of client-facing or customer service experience.

• 2 to 5 years of supervisory experience.

• More than 5 years of experience in commercial and government billing and collections.

• Demonstrated experience in hospital revenue cycle operations, emphasizing zero balance or underpayment recovery.

• Ability to pinpoint recovery opportunities within extensive claim inventories.

• Familiarity with payer portals, claims systems, and healthcare revenue cycle technology platforms.

• Expert knowledge of insurance payer and provider claims processing and data requirements.

• Experience supporting outsourced zero balance or contingency-based recovery programs.

• Strong computer skills, including proficiency in MS Office (Word, Excel, Outlook).

• Equivalent combinations of education and experience will be considered.

• Regular and reliable attendance is expected.

• Excellent interpersonal, coaching, mentoring, written, and verbal communication abilities.

• Strong analytical and problem-solving capabilities.

• Experience with external clients, customer service skills, and business acumen.

• Ability to prioritize and manage multiple competing priorities and projects.

• Capability to sit for extended periods.

🏝️ Benefits

• Support for professional growth and development.

• Access to tools, resources, and assistance for career advancement.

• A flexible, family-oriented work environment.

• Support for work-life balance.

• Option for remote work.