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30-Jun-2026
Appeals Supervisor
External Job Description and Responsibilities
Overview
The Appeals Supervisor provides leadership and guidance to the Appeals No Activity role in the No Activity workflow and the following two roles within the Rejections Workflow: Appeals and Charge Corrections.
The Appeals No Activity role is responsible for reviewing invoices that have previously been appealed but no response has been received. The appeals department is responsible for reviewing invoices based on rejection code to determine if an appeal is required and Charge Correction role will perform a charge correction on applicable invoices transferred from Coding department.
The Supervisor monitors, delegates, and researches daily productivity of assigned staff. Analyzes the A/R and identifies billing issues that could prevent untimely or delayed adjudication of claims. Plans processes for resolutions of A/R billing and collection problems. Make recommendations and communicates to other department supervisors to maximize reimbursements and minimize delays in adjudication of medical claims.
Essentials Duties and Responsibilities
Reviews weekly ETM PIT Reports to ensure worklists are being processed and maintained per department standards
Ensures all invoices by reporting category and division are being assigned properly
Reports to A/R Manager on the status of workload for department
Reviews staff productivity and maintain quality assurance policy and procedure guidelines
Manages department within budget guidelines
Processes RAC Audit requests
Reviews assigned edits listed on the Unbilled Charges Report
Recruits, hires, trains, leads, and motivates staff
Completes employee performance reviews
Maintains current and up-to-date technical competence in physician fee-for-service and managed care billing and insurance reimbursement
Manages staff and procedures ensuring systems operate efficiently and effective personnel relations are maintained
Disseminates timely billing communications to staff
Informs appropriate supervisors when obvious inappropriate business practices are evident, which may affect not only reimbursement and accounts receivable management, but also relationships with clients, hospital, and insurance payers
Completes special projects and reports as requested by the A/R Manager
Maintains a personal work schedule that allows her/him to be at work regularly and dependably
Complies with mandatory overtime requirements at the direction of the A/R Manager
Assumes other duties as assigned by A/R Manager and Assistant Vice President of AR
Communicates with the AVP and Manager regarding the timely progress of projects and assignments
Reports on any problems detected errors and/or changes to the Manager
Creates and maintains policies consistent with HCFS and Team Health policies
Participates in monthly progress meetings with staff regarding Accounts Receivable and system processes
Qualifications / Experience
Excellent knowledge of healthcare payer reimbursement for physician billing
Prior experience in managing appeals resolution
Excellent analytical, communication and interpersonal skills
Knowledge of ICD-9 and CPT-4 coding
Good team management skills
Good knowledge of Excel
Proficiency in working with systems (IDX-BAR experience is preferable)
Excellent follow-up skills
Excellent organizational skills
Minimum of (3) three years as a Senior/Lead and preferable five years total physician billing experience with specifically two years’ experience in Denials Resolution or A/R Management
Set in a high-volume, fast-paced office environment
Overtime may be required and can be mandated by Management
Occasional travel to seminar or training sessions may be required