Supervisor, No Surprise Act (NSA) Operations at Imagine360 in USA

Job description

• The Supervisor, No Surprise Act (NSA) Operations will oversee a team that works directly with providers, third-party organizations, and the Center for Medicare and Medicaid Services (CMS) to ensure fair and reasonable payments, and resolve issues at any level of the process. The process involves claims negotiations and final arbitration in Independent Dispute Resolution (IDR), with several strategic decision points along the way. The Supervisor of Surprise Billing Operations will oversee and refine organizational processes to ensure maximum efficiency and effectiveness.

Responsibilities

• Caseload Management.
• Regular 1-on-1 meetings with direct reports.
• Process review and improvement.
• Remote meetings with third party partners and, occasionally, clients.
• Train direct reports in accordance with department policies and procedures, and federal and state laws, to ensure successful NSA negotiations outcomes in IDR.
• Respond to issues, questions, and concerns from management, providers, clients, other partners, and the team, to ensure a smooth member and provider experience.
• Assist in hiring and training new candidates for the team.
• Monitor employee productivity and provide constructive feedback and coaching
• Work escalated, high dollar, and otherwise high-priority cases.
• Delegate special projects and cases as necessary.
• Work with Manager to develop and support successful completion of goals for the team.
• Maintain frequent communication with Manager to ensure efficient operations.
• Manage escalated inquiries from both internal and external parties.
• Develop and maintain department policies and procedures.
• Identify enhancements and changes to workflows to increase effectiveness and productivity.
• Manage and coordinate escalated issue resolutions with both internal and external parties.
• Assist and manage voicemails and phone calls.

Requirements

• College degree preferred but extensive experience without a degree would be considered
• Bachelor's degree in business or healthcare administration preferred or related field
• Minimum of 3 years of healthcare, health insurance, or customer service experience
• Minimum 1 year of supervisory experience
• Experience with the No Surprises Act
• Experience in billing, insurance, healthcare, or legal environments preferred
• Demonstrated success in supervisory role
• Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
• None

Skills

Required

• Supervisory skills
• Communication
• Coaching
• Problem-solving
• Organizational skills
• CMS1500 and UB04 Medical Claim Forms
• Medical coding
• Microsoft Office products

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives
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