Support Service Manager
Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talented individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
Ideal candidates will have a minimum of two years' experience in people management in addition to experience with provider demographics and offshore vendor management experience.
JOB SUMMARY: This position is responsible for managing all facets of assigned team(s) including planning, staffing, product evaluation and enhancement, and policies/procedures with focus on departmental and corporate goals including, but not limited to quality results, turn-around-time (TAT) and adhering to client performance guarantees to ensure smooth and efficient operations within assigned team(s).
JOB ROLES AND RESPONSIBILITIES:
1. Manage performance to ensure competent staff delivers quality results. This includes planning, training, mentoring, motivating, and overseeing staff performance to negotiate with providers on non-contracted facility and/or provider claims, provide effective and efficient analysis of non-contracted facility and/or physician claims, and consult on Bill Review agreement proposals with negotiators.
2. Give instructions and direction to direct reports and negotiators on individual cases.
3. Maintain client and provider relations by following up on questions and service issues that arise.
4. Complete and oversee special projects assigned by leadership.
5. Create and distribute goals and standards to subordinates regularly.
6. Oversee approval of specific claims and client specific results and implement corresponding improvement initiatives.
7. Participate in the development of policies and procedures based on current and future trends.
8. Collaborate, coordinate, and communicate across disciplines and departments.
9. Select, develop, and evaluate staff to ensure the efficient operation of department.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE: The individual incumbent works independently and exercises significant independent judgment. The individual incumbent will manage staff and help provide thorough and appropriate responses to clients and providers to meet the goals of the department. The individual incumbent provides input to make critical business decisions, including staffing and process improvement, and impacts day-to-day operations through the oversight of claim resolution and providing direction to staff on individual cases. The individual incumbent operates with appreciable latitude for unreviewed decisions and uses an extensive range of knowledge to complete job responsibilities.
Job Requirements:
JOB REQUIREMENTS (Education, Experience, and Training): * Minimum high school diploma and five (5) years' experience in the healthcare or managed care industry (e.g. clinical, provider financial, insurance, and/or managed care), two (2) years' of which should include experience effectively managing staff involved in negotiations and/or sales. Those with proven experience in management and negotiation skills from other professional sectors (particularly legal and/or financial) will also be considered. Bachelors' degree in a related field in preferred.
* Required licensures/professional certifications, and/or Board certifications as applicable
* Knowledge of:
o Claim production standards, claim inventory management, medical claim and provider billing procedures
o Provider billing and collection practices
o Effective negotiations principles
o Commonly used medical coding systems (e.g. CPT, ICD-9, revenue)
o Commonly used medical data resources (e.g., MDR, Redbook, Medical Fees in the US, etc.)
o HCFA-1500 and/or UB-92 medical claim forms
* Good Communication (verbal, written and listening), managerial, interpersonal, organizational, time management, negotiation/sales, problem solving, leadership skills
* Ability to:
o Adjust/alter workflow and schedule to meet deadlines in a fast-paced environment.
o Interpret data about a case, provider, client, or negotiator
o Prioritize and manage time
o Manage a team
o Make decisions using limited or incomplete data
o Manage multiple projects at the same time
o Use software, hardware, and peripherals related to job responsibilities, including MS Office
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical, dental, and vision coverage (low copay & deductible)
- Life insurance
- Short- and long-term disability
- 401(k) + match
- Generous Paid Time Off- 20 days of PTO accrued per year.
- Paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Summer Hours- from Memorial Day to Labor Day we get off two hours early on Fridays with pay company-wide.
The salary range for this position is $80-81k. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.