Remote SPVSR DENIALS & APPEALS (653560) bei Johns Hopkins Health System

Position Summary:

Reporting to the Clinical Audit and Appeals Manager, this position is responsible for supervising the resources that perform denial appeals processing for JHHS hospital entities by leveraging the systems and staff towards the achievement of daily, weekly, monthly, and fiscal year performance targets.  This individual will assist the Manager in leading, developing, and mentoring staff.  In addition, this role will supervise staff using the department’s operational policies, guidelines, and code of ethical standards which include respect, diversity, integrity, and collegiality.

The scope of responsibility includes appeals management for administrative and clinical denials by any managed care, commercial, or State/Federal insurance payers until the case is resolved.  The supervisor will train staff, conduct audits (staff performance metrics and denial prevention) and assist leadership with the development and enforcement of policies that align with the department goals and objectives. This position will work closely with the patient access, revenue integrity, care coordination, billing, and the compliance departments to ensure maximized revenue recovery on denied services and is responsible for establishing relationships at all facilities.

Location:  3910 Keswick Road, Baltimore, MD - REMOTE.

Hours: 40 hours/Days

Qualifications:

Knowledge:   

• At least two years of supervisory or lead experience preferred. 
• In-depth knowledge of revenue cycle operations, payer regulations, and appeal processes. 
• Proficient in Microsoft Office (Excel, Word, PowerPoint) and electronic health record systems (Epic).
• Experience in data analysis and report production. 
• Excellent interpersonal skills to handle sensitive and confidential information.  Must possess excellent communication skills to gather and exchange data.
• May serve as liaison between various departments on issues regarding registration, coding, medical record documentation, and appeals efforts. 
• Able to gather and interpret data from multiple sources and resolve problems.

Education:

Bachelor’s Degree in Business, Health Administration, or related field and a minimum of 8 years experience in healthcare revenue cycle or denials management.

Salary Range: Minimum 29.40/hour - Maximum 51.46/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

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Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.