Hmo Appeals Manager Jobs

Looking for qualified HMO Appeals Managers to join our team! We are searching for a HMO Appeals Manager to join our community that is a team builder, and excited about the opportunity to assist in building a culture. If you are a HMO Appeals Manager that has business acumen, is team-oriented, driven, and excited about the opportunity to build a culture, then we have the perfect opportunity for you! Interested? Perks and Benefits Pay rate: Competitive salary, along with holiday pay and unlimited Work Life Balance (WLB) program. Innovative Purchasing Program: We offer a purchasing program that allows you to buy thousands of products (technology, furniture, clothing, etc.) and pay over time. Zero interest, no credit check, no hidden fees. Access to online learning 24/7: Our Learning Management System offers over 1,500 courses for senior care, health and human services industry. Use it for free to help satisfy your personal and professional development. Data base includes, MS Office and Leadership/Supervisory content. Available via computer or mobile, and many courses are offered in alternative languages. Phone and auto discounts: Up to 20% on employee personal wireless accounts and auto rentals through designated vendors. Employee Assistance Fund: You are always there for others. Let us be there for you. In unexpected catastrophic situations you can confidentially apply for help. Major Responsibilities Lead, manage, and direct a team of AR Billing & Collection Specialists with responsibility for billing and collecting accounts receivable for multiple Skilled Nursing Facilities . This position is responsible for establishing strategic plans, goals and processes related to the HMO denial and appeal process for Skilled Nursing Facilities in multiple states. Develop strategic plans, policies and procedures to efficiently bill and collect accounts receivable (A/R) from third party payers. Lead and direct the daily activities of the HMO Appeals team, including training, work-flow assignments and employee development. Responsible for resolution of escalated/denied accounts with various payers in a timely manner. Serves as liaison with major payers for escalated/denied account resolution. Leads communication efforts of root cause analysis and recommends solutions to avoid future denials. Assist Skilled Nursing Facility office managers with complex accounts receivables questions. Work closely with other departments and facility personnel on accounts receivable issues. Responsible to ensure regulatory and internal reports are submitted timely and accurately. Provide innovative, responsible healthcare with the creation and implementation of new ideas and concepts that continually improve systems and processes to achieve superior results as well as the development of a successful management team . Minimum Qualifications Must possess Bachelor's Degree or five (5) years management experience in a healthcare billing/collecting setting. Must possess five (5) years' experience in healthcare billing and collecting with two (2) years minimum supervisor experience. Skilled nursing billing experience preferred. Point Click Care Billing System experience preferred. You must be qualified, compassionate, and dedicated to a job well done. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status. Job Posted by ApplicantPro