Supervisor, HCS Reclamation Operations (Cost Avoidance Verification)

ABOUT PERFORMANT:

At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most – quality of care and healthier lives for all.

If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture – then Performant is the place for you!

ABOUT THE OPPORTUNITY:

The Supervisor, HCS Reclamation Operations (Cost Avoidance Verification) oversees and supports daily business operations for Performant’s Post-Payment Reclamation-related solutions.  We are looking for a candidate with a strong knowledge of Medical claims billing and recovery. Must have a vast knowledge in Medicare regulations, Medical terminology, medical coding, forms UB04 and CMS 1500.  This role will require the ability to gather and interpret explanation of benefits (EOB) and Provider feedback to answer questions and assist recovery teams with Provider and Network communications.
They will leverage their knowledge in Medical and Rx billing and recovery, with a focus on Medicaid and Medicare rules and regulations; paired with leadership experience and adaptability to support team functions to make a positive impact in the growth of our overall recovery operations.  
They will play a key support role in continual improvement of recovery processes, procedures, and staff development.

Key Responsibilities

•Monitoring staff and daily recovery efforts
•Effectively collaborates with Management and teams to ensure departmental needs are met.
•Communicates with team to ensure all production goals are clear
•Leverages strong communication skills, both verbal and written, to assist recovery staff with escalated Provider and Network communications.
•Provides insight and collaborates to ensure appropriate staffing levels and staff competencies for assigned business
•Contributes to continual improvement of reclamation processes, procedures, and staff development
•Supports the organization in meetings with the clients and other reclamation business constituents as needed
•Assist with implementation of new accounts as needed
•Uses excellent communication skills to influence a wide range of internal and external audiences.
•Assists in development and revision of team training materials.
•Advises Leadership of operational training gaps, staff development issues and other observation and areas or opportunities that may involve training.
•Assist in operational training for staff to support operational quality and compliance, and optimal service delivery to clients as needed
•Leads by example and adheres to all Company policies and procedures in performance of job duties and all interactions

•Performs other duties as assigned.

Knowledge, Skills and Abilities Needed

•Working knowledge of Medicaid Third-Party Liability (TPL) business, recovery, and revenue cycle management
•Excellent professional written and verbal communication skills
•Proven experience leading and overseeing high performing dynamic teams
•Understands and adheres to HIPAA standards and regulations
•Strong critical thinking, analytical and problem-solving skills
•Self-motivated and thrives in a fast-paced business performing multiple tasks cohesively, with keen attention to detail
•Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs; and consistently performs job responsibilities
•Perform other duties as may be required to meet business needs

Required and Preferred Qualifications

•High School Diploma or GED required
•BA or equivalent combination of education and experience
•3 + years of Revenue cycle or Recovery experience.
•3+ years in a Healthcare claims or revenue cycle management environment.
•2+ years supervisory experience in fast paced production or call center environment.
•Some college or training in medical terminology, billing, coding, or Medical billing/Coding certificate.
•Extensive experience with provider outreach and communication.

WHAT WE OFFER:

Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview.

Physical Requirements & Additional Notices:

If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required.  Proof of such may be required prior to an offer being made.  It is the Employee’s responsibility to maintain this Internet access at their home office location.

The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary.

• Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.

• Regularly reads and comprehends information in electronic (computer) or paper form (written/printed).

• Regularly sit/stand 8 or more hours per day.

• Occasionally lift/carry/push/pull up to 10lbs.

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions).   Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.

• Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.

• Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures.

• Other requirements may apply.

All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant’s Human Resources team to discuss further.

Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED