Supervisor, Reconciliation

Company: Centene Corporation
Location: Austin
Posted on: June 9, 2021

Job Description:

Position Purpose: Oversee day-to-day operations, provide support to staff, investigate and resolve complex issues, and coordinate projects and initiatives.

Oversee all investigations related to appropriate coding practices, diagnosis and level of care (LOC) allocation and billing by hospitals in comparison of authorized services

Review authorizations to ensure quality and accuracy

Oversee & initiate investigation related to appropriate coding practices, diagnosis and level of care (LOC) allocation and billing by hospitals in comparison of authorized services

Manage all duties, coordinate daily work, and provide training and authorization updates as they relate to reconciliation coordinators

Ensure the quality of daily reviews of discharge reports of inpatient cases and reconciliation within CCMS system

Identify, track and analyze trends by type of error and provide feedback for staff training purposes and/or system configuration improvement

Monitor escalated and complex issues and recommend improvements to reduce errors

Maintain production and quality standards, claims authorizations and reconciliations

Ensure all reports are monitored & completed timely & accurately

Track patterns and trends, seeking solutions to improve authorization quality

Train and update staff regarding policies and procedures

Provide performance reports to management as needed

Education/Experience: Bachelor's degree in related field or equivalent experience. 2 years of related experience working with ICD-9, CPT and HCPC codes. Working knowledge of Provider and Claim systems. Claims examiner and/or claims processing experienced preferred. Lead or supervisory experience preferred.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Austin , Supervisor, Reconciliation, Other , Austin, Texas