Are you looking to take the next step in your career with a company that truly values and invests in its employees? We're excited to offer you the opportunity to join us as a Clinical Appeals Team Lead. Here, you come first. We've committed up to $300 million over the next three years to support our amazing team members.
BenefitsWe offer a comprehensive total rewards package designed to support your health, life, career, and retirement. Our plans and programs include:
Medical Coverage: Comprehensive plans covering many common services at no cost or for a low copay, including prescription drug and behavioral health coverage, free telemedicine services, and AirMed medical transportation.
Dental and Vision Benefits: Options for additional coverage.
Life and Disability Coverage: Flexible spending accounts and supplemental health protection plans (accident, critical illness, hospital indemnity).
Additional Insurance: Auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more.
Counseling Services: Free resources for emotional, physical, and financial wellbeing.
401(k) Plan: 100% match on 3% to 9% of pay based on years of service.
Employee Stock Purchase Plan: 10% discount on company stock.
Family Support: Fertility and family building benefits with Progyny and adoption assistance.
Referral Services: Assistance for child, elder, and pet care, home and auto repair, event planning, and more.
Consumer Discounts: Through Abenity and Consumer Discounts.
Retirement Readiness: Rollover assistance services and preferred banking partnerships.
Education Assistance: Tuition, student loan, and certification support, plus dependent scholarships.
Colleague Recognition Program
Time Away From Work Program: Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
Employee Health Assistance Fund: Offers free employee-only coverage to full-time and part-time colleagues based on income.
Note: Eligibility for benefits may vary by location.
Your Role and Impact
Every role here has a significant impact on our patients' lives. As a Clinical Appeals Team Lead, you will be a crucial part of our team, contributing to our mission of providing exceptional care. We're looking for a dedicated individual like you to join us and make a difference.
Job Summary And QualificationsWe are seeking a Clinical Appeals Team Lead who will oversee daily appeals follow-up, monitor denial trends/issues, and assist the Clinical Appeals Manager with training the appeals department. We are a supportive and hardworking team and are excited to welcome a phenomenal addition like you.
ResponsibilitiesProvide introductory and ongoing training and education to Clinical Appeals staff to ensure adherence to policies and procedures.
Communicate regularly with the Manager to resolve issues, set and prioritize goals, and improve processes.
Assist with staff communication, updates, issue resolution, goal setting, and maintaining standards.
Maintain departmental policies, objectives, and patient and customer service policies.
Assist with payroll activities for team members (e.g., time cards, edit sheets).
Help develop and implement project and department action plans.
Monitor insurance denials, run appropriate reports, and contact insurance companies to resolve claims denied for clinical reasons.
Identify and correct coding or clinical documentation issues promptly.
Identify problem accounts and escalate them as appropriate.
Update patient account records to document actions taken.
Work with guarantors to secure payment on account balances denied for clinical reasons.
Adhere to the "Code of Conduct" philosophy and "Mission and Value Statement".
Perform other duties as assigned.
QualificationsAssociate's Degree in Nursing required.
Prior Supervisory Experience Preferred.Minimum one year of case management experience required.
Relevant Education May Substitute For Experience Requirements.Current licensure as a registered nurse (RN) or licensed practical nurse (LPN) in the state(s) of practice and/or active compact license, in accordance with law and regulation.
We invite you to apply now and join our dedicated team. Make a meaningful impact with us!
Employment Type: Full-Time