Details: Supervisor, Revenue Integrity Operations (Medical)Performant Financial Corporation, parent to a number of companies is a leading specialized technology and services company delivering high value-added, technology based, knowledge process outsourcing solutions primarily to entities within government, Healthcare Services verticals. Performant’s services generally comprise core aspects of an organization’s operations and thus are “mission critical" in nature.Performant Financial Corporation is headquartered in Livermore, California, and employs 960+ people in five offices. We offer a competitive total compensation package, including health benefits, paid time off, 401k and life insurance. Additionally we have EAP, supplemental insurance and a scholarship program. Learn more about us at www.performantcorp.comTo apply: submit your resume to, including the job title in the subject line. Please confirm your salary expectation.Final compensation will be dependent upon education, skills and experience. As a Federal Contractor, employment with Performant requires you to be free of defaulted student loans, State or Federal liens and felony convictions. We are proud to be an Equal Opportunity Employer.Responsibilities:The Revenue Integrity Operations (RIO) Supervisor will be responsible for all day-to-day, hands-on operations of RIO department & its team. The Supervisor will have a team of 5 or more analysts. This position will be held accountable for ongoing development and maintenance of sound internal controls, accounting principles, practices and procedures to ensure accurate and timely processing of adjustments, AR’s claim payments/reversals, appeal tracking and subsequent CMS invoices and subcontractor billings and remittances. In support the day to day functions working toensure timely and accurate reconciliation preparation between internal & external client & vendor systems. Challenge processes in an effort to increase efficiency and mitigate risk. Validating appropriate processing and conducting downstream impact analysis of payments posted, reversed, adjusted and appeals are an essential function of this position. The position requires an individual who has demonstrated best practice process implementation and is able to set standards for team to operate effectively. It is essential that the right individual be strong in developing a team onsite & remotely to work well & utilize all resources within team effectively.We can offer you an exciting, fast-paced working environment, a culture of mutual respect and teamwork and the opportunity to play a vital role in our growth. If you are attracted to joining an organization where every individual's contribution counts and where your talent will impact on our future, please apply for this position. It starts with you. Accomplishes human resource objectives by partnering with department management in the interviewing, hiring, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; enforcing policies and procedures. Achieves operational objectives by contributing accounting information, spreadsheet analysis & aging’s; recommendations to strategic plans and reviews; preparing and completing action plans; execution of production, productivity, quality, and customer-service standards; resolving problems; completing audits; determining core systemic areas for improvements & providing requirements for execution of improvements; implementing change Responsible for all operational processes from adjustments submitted to MAC through invoicing and into appeals process & tracking Review & research a high volume of transactions, identifying causes of discrepancies & recognize resolutions, document issues & report proposed resolutions to management Ensure timely & accurate processing of all invoice processing and reconciliation Interface and communicate with technical departments regarding reconciliation of a high volume of transactions and data Assess process inefficiencies; provide detailed input as to the approach & programming required to enhance & improve process, capture appropriate data Provide analytical audit assistance with CMS audits, supporting action plans for process improvements as identified by management Ability to handle constantly changing situations and work within a diverse group Perform ongoing quality assurance functions and ability to recognize interdependencies and improve processes as necessary; providing recommendations to management on work-flow and process for improved efficiencies and accuracy Complete accurately & efficiently any and all tasks as assigned by department management Exhibit strong & professional customer service skills and ability to support & interact with internal departments and external vendors or clients to obtain critical research information for resolution of claim payments and/or appeals data. Other responsibilities include and keeping current with CMS contractual requirements and regulations Perform other incidental and related duties as required and assigned
No comments:
Post a Comment