Sobre esta vaga de Claims Resolution Supervisor na Innovative Hematology, Inc.
About IHI
At Innovative Hematology, Inc. (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.
What You Will Do
The Claims Resolution Supervisor provides day-to-day leadership and operational oversight for post-billing claim resolution across clinic and pharmacy revenue streams. The position supervises claim follow-up, denial and rejection resolution, appeals, underpayment recovery, payer correspondence, aging reduction, and timely escalation of high-risk accounts. Reporting to the Billing Operations Manager, this role serves as a peer to the Billing & Coding Supervisor and partners closely with that position to create a coordinated handoff from accurate claim submission through final adjudication and payment. The Supervisor develops staff, manages work queues and priorities, monitors key performance indicators, identifies root causes, and leads process improvements that accelerate cash, reduce avoidable denials, and strengthen payer accountability.
The Opportunity
- Supervise claims-resolution staff, including scheduling, timekeeping, workload allocation, coaching, quality oversight, and performance management.
- Ensure clinic and pharmacy claims are followed, corrected, reconsidered, appealed, escalated, and resolved within payer and organizational deadlines.
- Review complex, high-dollar, aged, denied, rejected, underpaid, recouped, or otherwise at-risk claims and determine the appropriate resolution path.
- Validate that account activity, payer correspondence, appeal support, expected reimbursement, adjustments, and final disposition are accurate and fully documented.
- Escalate payer processing failures, contractual disputes, access barriers, and material financial risks through established internal and external channels.
- Analyze operational and financial performance and take action to reduce aging, improve recoveries, accelerate cash, and prevent recurrence.
- Collaborate effectively with the Billing & Coding Supervisor and across Revenue Cycle, Clinic, Pharmacy, Finance, Compliance, Information Technology, and other departments.
Requirements
- High school diploma or GED required
- Associate or bachelor’s degree in healthcare administration, business, health information management, finance, or a related field preferred.
- Revenue-cycle certification such as CRCR, CPB, CPC, or an equivalent credential is preferred. Specialized training in denial management, payer appeals, contract reimbursement, or specialty pharmacy revenue cycle is strongly preferred.
- Five to seven years of progressive healthcare revenue-cycle experience with substantial responsibility for claims follow-up, denials, appeals, underpayments, and accounts receivable; experience supporting both clinic/professional and pharmacy or specialty pharmacy claims preferred. Prior supervisory or team-lead experience required.
- May substitute a post-secondary medical claims billing, coding, health information, or revenue-cycle degree or certificate for up to three years of work experience.
- All IHI employees are expected to enable multi-factor authentication via their personal smart phone/smart device in order to access IHI systems as a requirement of the role.
This position is open to residents of the State of Indiana, and requires routine presence at our Center in Indianapolis, IN. Frequency of on-site presence is dependent upon role and department needs.
Benefits
Why join our team?
IHI is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
IHI is the only federally designated comprehensive hemophilia program in Indiana and serves the entire state through services available in Indianapolis and at outreach clinics.
IHI is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
IHI participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions. The IHTC research program provides patients access to new therapies, and an opportunity to improve care. Our center has more than 50 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.