Supervisor, Escalation Unit - CATHOLIC HEALTH SERVICES OF LONG ISLAND : Job Details

Primary: Contributes to and consistently applies CHS Services policies, procedures, and benefits to all customers and/or employees without discrimination. Employee conducts himself/herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself/herself in conformity with the CHS Security policies and procedures. Analyze claims data with the goal of identifying and quantifying payment issues and trends in payer activity. Coordinates all facility credentialing with the managed care plans. Coordinates the validation of contracts as loaded in contract management systems. Works with Managed Care team on recovery efforts tied to identify variances. Conducts follow up activities with payers as assigned. Conducts rate analysis for rate recycling. Prepares and maintains revolving spreadsheets. Prepares settlement files. Assists in the development and maintenance of payer dashboards. Assists...Escalation, Supervisor, Healthcare, Business Services, Experience, Training