Claims Escalation Supervisor

Fast Pace Health strives to provide a best in class patient experience in every interaction. We are seeking a highly-skilled, experienced Supervisor - Claims Escalation to join our growing team. Our ideal candidate will be deeply committed to nurturing our Fast Pace mission of teamwork, communication, empowerment and quality care in a friendly and encouraging environment.

Fast Pace Health aims to push for a new vision of healthcare in rural communities that will consist of an array of different services. We are changing the delivery of healthcare in these rural areas by integrating excellent patient care, education, accessibility, and community service, in a way that puts the patient’s needs first and improves the health status of our communities.

Fast Pace Health is a growing company! You will have the support and mentoring you need to become the best Supervisor - Claims Escalation you can be! We will help you grow your professional goals, and can offer you a rewarding career path. We work as a dynamic team to surpass our business goals by ensuring our patients receive the best care possible in a positive environment. 

-We offer competitive compensation and benefits such as holiday pay, PTO, medical, dental, vision and Work-Life balance, to name a few. 

- As a Fast Pace Health employee you will have the opportunity to participate in community events and outreach programs. This includes, but is not limited to, seasonal parades, book drives, festivals, trunk or treating, fun runs, and more. We dress up for holidays and celebrate with pot lucks. At Fast Pace, our community is our family, and we are a family first community.

In a way that best supports our values, the Supervisor of Claim Escalation is responsible for leading the day-to-day operations of the Claims Escalation Team. Responsible for completion of performance evaluations, providing work direction and training, establishing goals, process improvements, productivity management, ensuring completion of assignments, tracking work to key performance indicators and approval/validation for time keeping records. Will collaborate with Human Resources team including Talent & Recruiting, People & Culture Partners & the Learning Academy to ensure their staff has all the necessary tools to perform their assigned task.  

Essential Functions:

PRIMARY

1. Manages the day-to-day functions of the claims escalation team, which consists of collecting and managing accounts, follow up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate) and following up on all denials to ensure processing/reprocessing and payments.
2. Will collaborate with other departments and vendors for and in the Revenue Services department to resolve conflicts and issues.
3. Monitors and works at streamlining denials and payment processing.
4. Implement and adhere to policies, procedures, and systems for claims escalation to ensure timeliness of collections.
5. Establishes controls and ensures denials worked are performed accurately and in a timely manner.
6. Establishes a follow up process to ensure denials are worked in a timely manner.
7. Coaches and develops staff knowledge of the practice management software and insurance guidelines.
8. Monitors task to improve cash practices and optimize reimbursement while maintaining a strong patient first approach.
9. Ensures accuracy to optimize efficiency while adhering to all regulations.
10. Ensure adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
11. Actively recommends new processes and procedures as needed to improve our overall process.
12. Motivates self and overall team and supports staff within the team to create a positive, productive and efficient work environment supportive of our values while meeting and exceeding our company goals.
13. Leads by example to staff within team and as a result overall staff in attitude and work performance that represents our values.
14. Interviews candidates for positions that report to the Supervisor – Claims Escalation as necessary.
15. Responsible for overseeing training for positions that report to the Supervisor – Claim Escalation and supporting training and coaching for those that report within the respective teams.
16. Responsible for overseeing performance and any related counseling of positions that report to the Supervisor – Claims Escalation up to and including recommendation for termination of employment.
17. Recognizes strong individual and team performance in support of our values and company goals.
18. Responsible for employees adhering to Standards of Operation, Core Values, and all other company policies.
19. Responsible for overseeing annual review process for positions that report to the Supervisor – Claims Escalation.
20. The ability to provide training to positions that report to the Supervisor – Claims Escalation on Company Standards of operations, and supporting training and coaching within their respective teams.
21. The ability to provide ongoing monitoring of standards by conducting standards testing on positions that report to the Supervisor – Claims Escalation.
22. The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
23. The ability to build and maintain confidence and credibility with all clients, vendors, and employees.
24. The ability to maintain friendly, cordial relations with all clients, vendors, and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
25. Ability to comply with Company Standards of Operations.
26. Ability to adhere to the Core Values of the Company.

SECONDARY

1. Analyze labor and work volume to determine staff level and coordinates with Manager Claims Escalation to meet work volume demands.
2. Creates, prepare, present and submit reports to management monthly and upon request.

Non-Essential Functions:

1. Perform other duties as assigned by management

Knowledge, Skills and Abilities:

Basic Requirements:

Education:

• Bachelor’s Degree in Business Administration, Healthcare Administration, or its equivalent, Preferred.

          AND/OR

Experience:

• At least 5 years in healthcare setting where they received an in depth understanding of the complete Revenue Services process.      

and

• At least 2 years of leadership/supervisory experience in a Healthcare setting where they received an in depth understanding of the complete Revenue Services Process

Fast Pace Health is committed to the principle of equal employment and creating an inclusive environment for the benefit of our employees, our patients, and our communities. We are an equal opportunity employer and welcome job applications from qualified individuals without regard to race, creed, color, ancestry, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, marital status, parental status, genetic information or any other legally protected characteristics or conduct.
Please refer to the links below for information regarding your rights under certain federal laws:
https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/fmlaen.pdf
https://www.dol.gov/whd/regs/compliance/posters/eppac.pdf
Mississippi Residents Only:
In Mississippi, Fast Pace requires pre-employment/drug/alcohol testing as a condition of employment. The law requires that Fast Pace notify applicants, in writing, upon application and prior to the collection of the specimen for drug and alcohol test, that they may be tested for “the presence of drugs [or alcohol] in their metabolites.” Miss. Code. Ann. § 71-7-3(5).