Job details

Reimbursement Variance Supervisor

At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here:

Flexible schedules and work-from-home opportunities
Strong track record of providing excellent work/life balance
Comprehensive benefits package and competitive compensation
Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.

What you’ll be doing:

The Reimbursement Variance Supervisor is responsible for managing staff performance and ensuring the reimbursement for contracted and governmental plans is as expected. The Reimbursement Variance Supervisor will strategize techniques for pursuing any payment variances through bulk appeals and identify cost-reduction procedures and ensuring the Contracts Database and Athena reflect the contract terms. This position is responsible for the direct supervision of a team of Reimbursement Variance Auditors with the potential to grow in correlation with business needs.

Daily oversight and supervision of the Reimbursement Variance Department
Plans, organizes, and directs the work activity of the reimbursement variance auditing team, leading to excellent quality and production results
Manage inventory to ensure departmental goals are met
Develop processes for each project type based on prior project results and existing Policies and Procedures
Analyze identified contracted payer claims issues
Determining priority of payment projects
Maintain all auditing databases to ensure accurate audits
Summarize and report on audit findings in key policies
Identify opportunity for contracting and revenue recovery
Collaborate with managed care plans regarding resolution of claims projects
Collaborate with leadership regarding claims issues and decisions
Maintenance of the managed care contract database
Performance reviews and evaluation of reimbursement variance auditing team
Responsible for overall team development with regard to customer focus, performance improvement/reengineering, process management, motivating others, drive for results, and quality/timely decision making
Project oversite for the transition of down codes appeals
Manage the down coding build in the system
Identify opportunity for appeal cost reduction and atomization
Collaborate with MGS client’s request and appeal processing

Who/What we are looking for:

Bachelor’s degree or equivalent health care work experience
1-2 years’ experience in the health care preferably in billing or appeals & denials
Demonstrated ability to make decisions independently
Experience in Emergency Medicine billing and/or Healthcare reimbursement
Experience in Customer Service – external and internal
Familiar with a variety of the field's concepts, practices, and procedures
Knowledge of state and federal insurance laws
Relies on experience and judgment to plan and accomplish goals

To learn more about SCP Health, please visit:
www.scphealth.com

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SCP Health is an Equal Opportunity Employer.

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SCP Health Glassdoor Company Review

3.9

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CEO of SCP Health

Rich DAmaro

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By SCP Health

Our culture of service, dignity, and respectfulness to our team is unparalleled in this industry. Our patients, clinicians, and healthcare partners consistently say the same thing: “You not only deliver great quality care, you do the right thing.”...

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FUNDING

Growth

DEPARTMENTS

Other

SENIORITY LEVEL REQUIREMENT

Mid-Level

INDUSTRY

Health Care Services & Hospitals

TEAM SIZE