Audit Services Supervisor

Overview

The Audit Services Supervisor will lead the Audit Services team in completing audits and medical records requests for Embark Behavioral Health programs. Responsibilities include ensuring timely responses to insurance pre- and post-payment audits, tracking audit-related activities, and maintaining records in the billing system and audit workbooks.

This role requires a professional, self-motivated, and detail-oriented individual who can thrive in a fast-paced, high-stress environment. The supervisor will oversee daily team functions, support Audit Services Coordinators, manage audit appeals, analyze denial trends, and collaborate with program and RCM leaders for process improvements. Additionally, they will ensure accurate processing of medical records requests in compliance with HIPAA and other regulations while verifying the legitimacy of each request.

Pay: $65,000 - $69,000 Annually

Responsibilities

• Manage workflows to ensure timely audit and record requests are reviewed, monitored, and responded to in a timely manner and accurately.
• Serve as subject matter expert with all things related to audit services, to include managing workflows, workload balances, and partnering with program leaders.
• Become acquainted with insurance payment criteria, particularly for those payors hosting an audit.
• Drive audit and record to ensure we are maximizing insurance payments.
• Partner with programs to continuously improve documentation as related to insurance criteria.
• HR responsibilities to include recruiting, interviewing, hiring and training of new staff; providing one-on-one’s and constructive and timely performance evaluations, employee development; and handles discipline and termination of employees in in accordance with company policy.
• Provide oversight to the Audit Services team and actively participate in workloads to remain a subject matter expert in all things related to the department.
• Ensure validity and integrity of all patient insurance records.
• Provide feedback on deficiencies identified on any audit by reporting findings to the UR Director and related programs. Documentation needs will be addressed to ensure compliance with payors.
• Responsible for overseeing the release of medical information to insurance companies and any other requesting entity.
• Ensure all requests for records are worked on a first in first out basis, unless otherwise requested by the Utilization Review Director.
• Engage in denials and appeals.
• Make recommendations to define and improve quality of processes.
• Maintain productivity standards to effectively handle multiple, concurrent priorities and consistently meet deadlines.
• Performs quality checks on all work to ensure accuracy of the response and confidentiality.
• Maintain a good working relationship within the RCM department and with program personnel.
• Adhere to Embark BH and RCM requirements, policies, and standards.
• Provide excellent customer service by being attentive and responsive to requests.
• Other duties as assigned and appropriate.

Qualifications

Preferred Skills:

• Leadership Experience
  • Previous experience leading, hiring, developing teams

• Commercial Insurance Audit or Billing Experience
  • Previous experience working with commercial insurances in a audit or billing capacity

• Stakeholder Relationship Building
  • Proven success in developing partnerships with internal stakeholders.

• Technology and Systems Knowledge
  • Proficiency in Learning Management Systems (LMS) and other training delivery tools.
  • Familiarity with clinical software systems for integration and data tracking.

• Experience in Behavioral Health or Medical Healthcare Settings
  • Understanding of the unique challenges within behavioral health or healthcare organizations.

• Excellent Communication and Presentation Skills
  • Experience presenting to executive leadership, facilitating workshops, and delivering training to diverse audiences.

High School diploma or equivalent is required, associate or bachelor’s degree preferred.

Benefits

• Professional growth opportunities driven by cutting-edge strategies and training, guided by exceptional leaders
• Comprehensive benefits, including health, vision, and dental insurance with substantial company contributions, matched 401k plans, life insurance, long-term disability coverage, ample paid time off, company holidays, and paid maternity leave
• PTO accrual schedule
• Join a team of nationally recognized industry leaders who provide you with a framework of training, support, and long-term advancement opportunities.
• A strong culture that embraces the core values of empathy, trusting relationships, service, growth, and results

Embark is an Equal Employment Opportunity Employer. Embark is committed to enriching the therapeutic and healing experience it offers through the diversity of its employees and community. Embark seeks to recruit and support a broadly diverse staff who will contribute to the organization's excellence, diversity of viewpoints and experiences and relevance in a global society.

Salary : $65,000 - $69,000