About this opportunity
Advanced Pain Care lists this Accounts Receivable Supervisor opportunity in austin, Texas. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Job Type
Full-time
Description
Job purpose
The Appeals Lead provides advanced oversight of insurance denial and underpayment management, serving as both a senior technical expert and operational leader within Revenue Cycle Management. This role is responsible for managing complex appeals, monitoring denial and appeal performance trends, training and mentoring Appeals Specialists, and ensuring consistent execution of best practices. The Appeals Lead plays a critical role in driving improved reimbursement outcomes, reducing preventable denials, and promoting accountability through KPI monitoring and staff development.
Duties and responsibilities
Appeals and Denial Management
Reviews unpaid, underpaid, and denied claims to determine appeal viability, with a focus on high-dollar, high-risk, and complex cases.
Prepares, reviews, and submits written appeals, grievances, and reconsideration requests with complete and accurate supporting documentation.
Provides quality review and guidance on appeal letters prepared by Appeals Specialists to ensure accuracy, compliance, and effectiveness.
Researches payer contracts, policies, medical necessity criteria, and regulatory guidelines to support appeal arguments.
Interprets ERAs, EOBs, zero-pay remittances, and payer correspondence to ensure correct reimbursement.
Ensures all appeals are submitted within payer-specific, contractual, and regulatory timelines.
Denial Trend Analysis and KPI Oversight Oversees denial and appeal tracking processes to ensure accurate and consistent data capture.
Monitors and analyzes denial trends by payer, denial reason, procedure, provider, and department.
Tracks and reports key performance indicators (KPIs), including but not limited to: DAR; Days in AR
Percent paid by 91st day
Period Buckets
Team and individual productivity
Appeal success and overturn rates
Dollars recovered
Aging of appealed claims
Denial volume and repeat denial patterns
Prepares and presents detailed denial and appeal performance reports for leadership.
Identifies root causes of denials and recommends process improvements to reduce future occurrences.
Partners with leadership to establish performance expectations and benchmarks for the appeals team.
Training, Mentorship, and Team Support Trains new Appeals Specialists on appeal workflows, payer requirements, denial types, documentation standards, and best practices.
Provides ongoing coaching, mentoring, and performance feedback to Appeals Specialists.
Develops and maintains training materials, workflows, and reference tools related to appeals and denial management.
Monitors individual and team performance against KPIs and supports corrective action or additional training as needed.
Serves as a subject-matter expert and escalation point for complex appeal and denial issues.
Leadership and Cross-Functional Collaboration Collaborates with billing, coding, clinical, utilization review, and front-office teams to resolve systemic denial issues.
Provides actionable feedback to improve documentation, coding accuracy, and front-end claim submission practices.
Participates in audits, payer reviews, and special revenue optimization projects.
Demonstrates accountability for appeal outcomes and continuous process improvement initiatives.
Billing and Accounts Receivable Support Manages assigned and make assignments for Accounts Receivable worklists and follow-up activities as needed.
Assists with posting insurance and patient payments accurately and timely.
Submits corrected claims and documentation in electronic or paper format as required.
Contacts insurance carriers regarding claim status, payment discrepancies, appeal decisions, and refunds.
Patient and Customer Service Assists with complex patient billing inquiries and escalated issues.
Coordinates medical and billing documentation with patients and third-party payers.
Ensures professionalism, accuracy, and empathy in all patient communications.
Compliance and Professional Standards Maintains strict confidentiality of patient, provider, and company information in accordance with HIPAA and organizational policies.
Ensures appeals and documentation comply with federal, state, payer, and contractual requirements.
Maintains regular and predictable attendance.
Requirements
Previous coding experience preferred, not required.
Working conditions
Environmental Conditions : Medical Office environment
Physical Conditions :
• Must be able to work as scheduled - typically from 8:00 - 5:00 M-F
• Hybrid located at HQ Office
• Must be able to sit and/or stand for prolonged periods of time
• Must be able to bend, stoop and stretch
• Must be able to lift and move boxes and other items weighing up to 30 pounds.
• Requires eye-hand coordination and manual dexterity sufficient to operate office equipment, etc.
Salary Description
$30.00/ hour
Worksite address
austin, TX, 78716, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.