Supervisor, HCS Specialty Recovery

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs. The Healthcare Specialty Recovery Supervisor is a highly skilled, talented medical billing, revenue specialist with a strong knowledge of medical claims billing and recovery. Must have a vast knowledge in Medicare regulations, medical terminology, medical coding, forms UB04 and CMS 1500. Strong Medicare procedural background, familiarity with procedural challenge regulations. Experience in data mining, auditing, and concept development; the ability to gather and interpret explanation of benefits (EOB) and Provider feedback to answer questions and assist recovery teams with Provider and Network communications. They will play a key role in continual improvement of recovery processes, procedures, and staff development. They will leverage their expertise in Medical billing, recovery, and data mining with knowledge in Medicare rules and regulations. Paired with leadership experience and adaptability to support team functions to make a positive impact in the growth of our overall recovery operations.

Key Responsibilities

Monitoring staff and daily recovery efforts. Responsible for driving recovery team’s daily productivity, ensuring team is adhering to goals and SLAs. Program outreach as required, working with Providers and Networks as needed at the request of team members and Management. Effectively collaborates with Management and teams to ensure departmental needs are met. Communicates with team to ensure all production goals are clear, understandable, and achievable. Work with Leadership to set production goals as needed to meet department expectations. Provides feedback coaching and training to team members as required by management. Occasional assistance with Audit Concept development and claims review. Works with Healthcare Service’s leadership to ensure assigned areas are staffed appropriately to achieve recovery goals. Assist in development and revision of team training materials as needed. Contribute to development or enhancement or operational and recovery procedures, policies, and tools. Advises Leadership of operational training gaps, staff development issues and other observation and areas or opportunity that may involve training. Perform other duties as assigned. Knowledge, Skills and Abilities Needed Working knowledge of recovery and revenue cycle management. Strong knowledge of Medicare requirements and regulations. Proficient in MS Office, MS word, PowerPoint, and Excel. Strong communication skills, both verbal and written are required, to assist recovery agents with escalated Provider and Network communications. Ability to manage multiple tasks and priorities to meet department deadlines and expectations. Proven Experience in developing and maintaining a high performing production team. Strong interpersonal skills that lead to positive interactions with staff, peers, leadership, and stakeholders, with a demonstrated ability to assist in conflict resolution. Self-Motivated, thrives in a fast-paced office environment while performing multiple tasks cohesively, with keen attention to detail. Ability to work full-time and on site/ or remote as needed to meet business needs. Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs: and consistently performs job responsibilities. Ability to lead group activities and discussions that result in effective knowledge transfer, development and or desired business outcome. Strong critical thinking and problem-solving skills Required and Preferred Qualifications High School Diploma or GED required. Bachelor’s degree in relevant field or equivalent combination of education and experience. 3 + years of Revenue cycle or Recovery experience. 3+ years in a Healthcare claims or revenue cycle management environment. 2+ years supervisory experience in fast paced production or call center environment. Some college or training in medical terminology, billing, coding, or medical billing/Coding certificate. Extensive experience with provider outreach and communication. What We Offer: Work from anywhere in the US! Machinify is digital-first. Top Medical/Dental/Vision offerings FSA/HSA Tuition reimbursement Competitive salary, 401(k) with company match Additional health and wellness benefits and perks Flexible and trusting environment where you’ll feel empowered to do your best work The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Pay range: $61,000 - $73,000 Equal Employment Opportunity at Machinify We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/