Supervisor, Document Retrieval

Position Overview:

As part of the Price Optimization division, this role assists the Manager with operational leadership over the Document Retrieval Department. The supervisor will be responsible for managing the Document Retrieval I staff and monitoring the effectiveness of the process to request and obtain billing documents as well as provide training/mentorship for Document Retrieval I staff.

What you will do:

• Manages DR I team who assist the nurse auditors in the medical claim audit process by requesting UB/IBs applicable for pre-pay and post -pay documents from medical providers nationwide.

• Monitor and Audit DR I’s on outstanding claims and quality of uploads

• Assist with inventory assignment for all team members

• Provide new hire training and mentors’ new staff on proper claims processing.

• Manage and monitor team production and goals for DR I; ensuring quality standard are met to ensure accuracy in documents received and uploaded

• Coach and mentor DR I team members on exceeding expectations, evaluate performance on an ongoing basis and is responsible for monthly feedback to team and for conducting annual performance reviews

• Serve as a source of reference and escalation for questions, clarification and resolution for DR I team

• Participate in the hiring of new hires.

• Conducts payroll and WorkDay management responsibilities for DR I.

• Meets or exceeds Quality Objectives established by the DR department.

• Process all outside record retrieval portals for submission, downloads and logging

• Responsible for maintaining special work queues (i.e. Air ambulance, Nurse manager)

• Identifies and participates in Process Improvement Initiatives. Offers concrete recommendations for process improvement.

• Collaborate with Manager on DR Operations

• Meet with the leadership on a weekly/monthly basis to report overall functions of the department

• Partner with other Business Leaders to establish workflow efficiencies and resolve escalated/priority items with appropriate urgency

• Performs other related responsibilities as assigned.

• Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.

What you will bring:

• Associate’s degree or equivalent work experience within Payment Integrity

• 2+ years of medical claim experience

• Direct people management of a complex team of individuals; Hires, promotes, assess performance and other people’s decisions, coached, mentors, role models of company values, role models diversity, inclusion and wellness

• Knowledge of provider billing processes and techniques in obtaining documents

• Knowledge of itemized billing and HCFA claim documents

• Management of strategic operational and technology initiatives. Experience managing projects and process innovative changes effectively.

• Strong working knowledge of MS Excel, computer systems, applications and operating systems.

• Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.

• Excellent customer service and telephone skills.

• Demonstrated thought leadership and motivation skills, a self-starter with an ability to research and resolve issues

• Excellent skills in critical thinking and analysis, project management, meeting facilitation, and interpersonal interactions (e.g., partnering, conflict management, consulting, etc.)

• Ability to manage and prioritize multiple tasks

• Ability to work under pressure and meet deadlines

Location and Workplace Flexibility: We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, m