Manager, Clinician Appeals

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🕒 Maio 20

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

👔 Gerente

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CorroHealth

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

⚕️ Seguro de Saúde

☁️ SaaS

🤖 Inteligência Artificial

Healthcare Insurance • SaaS • Artificial Intelligence

CorroHealth é um provedor líder de análises de saúde clinicamente orientadas e soluções impulsionadas por tecnologia, focado em melhorar o desempenho financeiro de hospitais e sistemas de saúde. Suas soluções integradas e tecnologias avançadas visam otimizar todo o ciclo de receita, oferecendo serviços como gestão do ciclo de receita, documentação clínica, codificação médica e gestão de recusas. Com um compromisso de melhorar a saúde financeira por meio de tecnologia inteligente e orientação especializada, a CorroHealth aborda complexas relações entre pagadores e prestadores e apoia operações de saúde eficientes.

Descrição

• The Manager of Clinician Appeals is a clinical leader responsible for the strategic oversight and operational execution of the appeals letter writing and client education engagement. • Lead high-performing clinical teams in the development of clinically accurate, persuasive, and compliant appeal communications to payers. • Ensure operational excellence, clinical integrity, and alignment with financial goals. • Work closely with internal leadership, administrative operations, and external clients to ensure best-in-class service delivery in a dynamic revenue cycle environment. • Analyze denial types, identify root causes, and deliver actionable feedback that helps prevent future denials. • Manage and develop both domestic and global clinicians who write appeal letters. • Oversee hiring, onboarding, training, and performance management of clinical writers. • Define and implement the team’s leadership structure and workflows. • Enforce quality and productivity standards; take corrective action as needed to maintain high performance.

🎯 Requisitos

• RN, MD or DO license required; active, unrestricted medical license (any state) preferred • Minimum 8+ years of clinical experience with at least 5 years in a leadership role within appeals, utilization management, clinical documentation improvement (CDI), or similar RCM functions • Strong knowledge of payer appeals processes, healthcare regulations, and documentation standards • Demonstrated success in managing clinical teams in a high-volume, fast-paced environment • Proven experience developing QA programs and implementing clinical workflow improvements • Strong understanding of financial models and operational KPIs in the revenue cycle industry • Exceptional communication, collaboration, and leadership skills.

🏖️ Benefícios

• Professional development • Flexible work arrangements