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Job #10197
Revenue Cycle Denials Supervisor
Patient Billing/Credit Department
Full Time, Days
Lawrenceville, NJ
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Responsibilities:
  • Directly supervises Denial Process Representatives.
  • Obtains a thorough understanding of payer reimbursement practices and procedures.
  • Manages work queues to ensure proper allocation of work among staff and to identify required work queue changes. Coordinates with Patient Accounts to correct all work queue issues.
  • Monitors staff productivity and performance, as well as team goals.
  • Troubleshoots any issues between Patient Accounts, Operations and Denial teams. Escalates to the Manager, if needed.
  • Establishes written processes for denial review and appeals.
  • Identifies trends and issues in payer denial adjudication through ongoing interactions with staff, and escalates these to the Data Specialist and Manager.
  • Assists Manager in formulation of appeal letters to ensure they include relevant and effective clinical documentation from the medical record, ensures they are supported by current industry clinical guidelines, uses evidence-based medicine, and includes local and national medical management standards and clinical protocols.
  • Remains current with changes in payer medical policies, authorization procedures and any other issues that impact denials. Communicates changes to staff for incorporation into the appeals process.

Requirements: 
  • High school diploma or equivalent.
  • Bachelor’s degree preferred.
  • Five years' experience in hospital-based billing.
  • Supervisory experience preferred.
  • ICD-10 knowledge preferred.
  • Proficient knowledge of healthcare billing.
  • Outstanding organizational skills.
  • Excellent verbal and written communication skills.
  • Proficiency in Microsoft Office.
  • Ability to quickly learn the billing system to become proficient.
Capital Health is the region's leader in advanced medicine with significant investments in advanced technologies and the best physicians. Comprising its two hospitals (Capital Health Regional Medical Center in Trenton and the Capital Health Medical Center - Hopewell) and the Capital Health - Hamilton outpatient facility, Capital Health is a growing healthcare organization that is accredited by The Joint Commission.

Capital Health has also received Magnet® status for the fourth consecutive time in recognition of its quality patient care, innovations in professional nursing practice, and nursing excellence. Only 29 organizations in the country have received Magnet status four times and five of those organizations are in New Jersey. In addition, our nursing team received special recognition for excellence in stroke and outpatient emergency care.

We offer competitive compensation and benefits that include:
  • Tuition reimbursement
  • Low employee expense for medical and dental insurance
  • 403b savings and retirement program
  • Educational assistance program

Find out why our 3000+ employees have chosen Capital Health.

Easy commute from PA and major NJ routes.


Learn more about us:
www.capitalhealth.org

Equal Opportunity Employer.