Supervisor, Revenue Cycle Audits - Authorizations

The Supervisor, Revenue Cycle Audits (RCA) will supervise the authorizations focus area and is responsible for profiling, researching, and resolving reimbursement issues for assigned payors, products, lines of business, and other variables as well as leading a team of both onshore and offshore auditors. The RCA Supervisor reports directly to one of the Manager in Revenue Cycle Audits. This role involves a mix of leadership, analytical, and quality responsibilities such as overseeing audit work and filling in as needed, identifying trends & issues, and providing insights and opportunities for improvement. They will also draw logical conclusions, provide actionable recommendations, and create data-driven forecasts from implementing strategies that can improve business performance, which they will then share with leaders.

PRIMARY RESPONSIBILITIES:

Mentoring/Coaching
● Exemplify a culture of empathy, high performance, and accountability and serve as a coach and
mentor to the team
● Perform ATA (Audit the Auditor) process to ensure quality and provide feedback to audit team
● Supervises, trains, provides work direction, and problem-solving assistance for audit team as well
as overseeing the daily operations of other staff
● Ability to present and communicate detailed information to stakeholders
Auditing/Quality Assurance
● Perform detailed and comprehensive audits on accounts to ensure steps within the billing lifecycle
are conducted accurately and according to industry best practices
● Assist with tracking QA results and quality SLA reporting
● Assist with developing and maintaining a robust quality assurance process
● Provide detailed audit results to operational leaders to help drive accountability, identify areas for
remedial education, and process improvement
Accounts Receivable Management
● Analyze and review complex accounts to investigate and determine root cause of AR issues
● Assist with the development and implementation of best practice workflows and
processes to ensure timely collections and effective denial management
● Work with Billing Strategy Directors and Product Managers to formulate a plan to
improve revenue per case by owning projects related to billing lifecycle such as demographics,
eligibility verification, pre-authorization, coding, claims management, payment posting, denials
management, AR management, patient statements/billing, etc
Process Improvement
● Consistently seek opportunities within billing lifecycle to enhance efficiency and accuracy in both

● Work cross-functionally within operations to help streamline billing lifecycle with AR reduction
strategies (i.e., mitigate denials) leveraging industry best practices
Reporting and Analysis
● Conduct thorough analysis for clarity of data to identify trends, potential issues, root cause, and
opportunities …