Supervisor, Zero Balance Denials (REMOTE)
Core
Lead and oversee the recovery of hospital claims deemed 'zero balance' and closed by client hospitals, utilizing deep knowledge of reimbursement, coding, and payer behavior to identify recovery opportunities.
Role type
Senior IC healthcare revenue cycle supervisor (zero balance recovery)
Builds
Recovered funds for hospitals, health systems, and ambulatory surgery centers
Domain
Healthcare revenue cycle management / Specialty RCM
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Hospital reimbursement expertise, medical coding (CPT, ICD-10, modifiers), payer behavior analysis, zero balance recovery strategy, team supervision and coaching, performance management, quality control review, claim payment analysis, appeal letter preparation, medical records research, insurance follow-up, MS Office proficiency
Preferred skills
Associate's or Bachelor's degree, experience with outsourced contingency-based recovery programs, data analytics collaboration
Technologies
EnableComp E360 RCM platform, payer portals, claims systems, MS Office (Word, Excel, Outlook)
Responsibilities
Provide daily supervision, coaching, and support to assigned Zero Balance team members; Manage the full employee lifecycle including hiring, onboarding, training, performance management, and corrective action; Identify and pursue recovery opportunities within large inventories of zero balance hospital claims; Analyze and evaluate claim payments using proprietary systems to determine compliance with contractual reimbursement; Prepare and submit initial bill packets and appeal letters; Conduct timely and thorough follow-up with insurance companies to drive correct reimbursement; Research, request, and compile medical records, implant invoices, and other supporting documentation required for claim resolution; Serve as the primary escalation point for team member issues related to access and roadblocks impacting claim resolution; Collaborate with Data Analytics and Product teams to investigate calculation issues and support special projects.
Seniority
Senior, hands-on IC with people leadership