Supervisor, HCM Medical Cost Programs Job in Newark, New Jersey US
Coordinate department activities and special projects. Supervise staff in accordance with company policies and procedures.
This position is required to adequately support, manage and oversee auditing teams responsible for review of appropriateness of billing and / or services rendered: day-to-day oversight and inventory tracking and management for claims, appeals, SRs, MAC case preparation and third party appeal cases.
Job Qualifications
Education/Experience:
- Requires a bachelor's degree in a related field or equivalent experience.
- Requires a minimum of ten (10) years of experience within the Healthcare Industry.
- Requires minimum four (4) years supervisory experience, preferably in the healthcare industry
Additional licensing, certifications, registrations:
- Prefer Certified Professional Coder certification
- Prefer RHIA or RHIT certification
- Prefer CCS
Knowledge:
- Knowledge of Healthcare Industry and claims coding required.
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications.
- Appropriate system knowledge for effective inventory management is necessary: UCSW, NASCO, Qblue and lotus notes databases.
Responsibilities
Additional Requirements
Supervisor for the Clinical Auditing Monitoring Unit; oversee a team of Certified Coders and clinical analysts; perform prepayment reviews of medical necessity. Position will have direct responsibility for managing and reporting on pend and USCW/Inquiry Inventory. Oversight of staff performance and developmental plans; contributes to mid and annual reviews. Oversees department budget.