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Clinical Document And Recertification Team Lead

hace 4 semanas

Alajuela, Costa Rica 3M A tiempo completo

**Job Description**:
Collaborate with Innovative 3Mers Around the World

Brief Description of the role.
The Supervisor of Clinical Document and Recertification Team is responsible for evaluating and routing US centric clinical documentation received to the appropriate team, follow up process for US insurance companies' authorization requests for V.A.C.
® Therapy and outbound contact to customers and patients as needed.
The team will receive and review information about wound progression for patients on V.A.C.
® Therapy as well as the needed documentation that allows for 3M to bill and be paid for our services.
The role will ensure team members are following all insurance requirements and statutory regulations related to US Healthcare Billing.
The Impact You'll Make in this Role:

- Ensure team members evaluate and route incoming Clinical Documentation to the appropriate department for review and processing
- Ensure team members follow up on online authorization requests timely and escalate any anomalies to the correct department
- Manage volume of outbound calling to patients to obtain correct caregiver information
- Evaluate staffing and work volume daily, adjusting assignments to meet Service Levels for each task
- Monitors key production and quality reporting to ensure team is following processes and cascades up through management chain
- Motivate, coach and develop team members to ensure achievement of team metrics, forecasts and goals
- Identifies opportunities for improvement in internal and external processes.
Identifies root-cause and develops action plan to address opportunities.
- Ensures fair, consistent and equitable treatment of 3M employees, by utilizing established 3M policies

What we are looking for:

- High school diploma/GED or higher (completed and verified prior to start) from an accredited institution?
- Two (2) years of successful operations leadership experience in a private, public, government, or military environment

Additional qualifications that could help you succeed even further in this role include:

- Knowledge of Wound Management principles and Clinical Documentation requirements and medical terminology in general
- Knowledge of US Healthcare Billing rules and regulations
- Knowledge of post acute market; including Home Health Agencies, Skilled Nursing Facilities, Wound Care Centers

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