Manager, Clinician Appeals

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🕒 il y a 22 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟠 Senior

🔴 Expert

👔 Manager

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CorroHealth

Site WebLinkedInTous les Emplois

5001 - 10000 employés

⚕️ Assurance santé

☁️ SaaS

🤖 Intelligence artificielle

Healthcare Insurance • SaaS • Artificial Intelligence

CorroHealth est un fournisseur de premier plan en matière d'analytique de santé dirigée cliniquement et de solutions technologiques, axé sur l'amélioration de la performance financière des hôpitaux et des systèmes de santé. Leurs solutions intégrées et technologies avancées visent à optimiser l'ensemble du cycle de revenus, en offrant des services tels que la gestion du cycle de revenus, la documentation clinique, le codage médical et la gestion des refus. Avec un engagement à améliorer la santé financière à travers une technologie intelligente et des conseils d'experts, CorroHealth aborde les relations complexes entre payeurs et prestataires et soutient des opérations de santé efficaces.

Description

• 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.

🎯 Exigences

• 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.

🏖️ Avantages

• Professional development • Flexible work arrangements