Supervisor, Specialty Testing Denial Management / Appeals - HYBRID

Job Responsibilities

• Supervise, coach, and support Denial Management Billing Specialists and other assigned staff.
• Establish performance expectations, monitor accountability, and address performance outcomes.
• Conduct one-on-one meetings, team huddles, coaching sessions, and performance discussions.
• Complete performance evaluations and employee development plans.
• Participate in recruiting, interviewing, hiring, onboarding, training, cross-training, succession planning, and retention activities.
• Assess staffing and capacity requirements, manage schedules, approve time-off requests, and escalate resource risks impacting operational performance.
• Oversee the review, analysis, prioritization, preparation, submission, and follow-up of denied and underpaid insurance claims.
• Ensure appeals are completed accurately, timely, and with required supporting documentation.
• Serve as the primary escalation point for complex claims, coverage, coding, billing, reimbursement, and payor issues.
• Monitor performance against key operational metrics including productivity, quality, aging, appeal turnaround time, overturn rate, inventory management, and cash collections.
• Ensure adherence to payor policies, contractual requirements, standard operating procedures, internal controls, HIPAA regulations, CMS guidelines, Medicare requirements, Medicaid requirements, and other applicable regulations.
• Conduct workflow, documentation, and performance audits.
• Implement corrective actions, education plans, and operational controls to reduce errors and compliance risks.
• Analyze denial trends and root causes by payor, procedure code, diagnosis code, testing type, workflow, location, and other operational attributes.
• Develop and implement denial prevention and reimbursement recovery strategies.
• Lead process improvement initiatives designed to reduce avoidable denials, improve appeal success rates, accelerate reimbursement timelines, and increase cash collections.
• Prepare and present operational performance updates, trends, risks, and recommendations to leadership.
• Partner with Billing, Coding, Prior Authorization, Reimbursement, Client Services, Laboratory Operations, Compliance, IT, and payor-facing teams to resolve systemic reimbursement issues.
• Support technology and workflow implementations through business requirements gathering, user acceptance testing, change adoption activities, and post-implementation monitoring.
• Develop and maintain standard operating procedures, job aids, escalation processes, and training materials.
• Escalate operational, compliance, staffing, payor, and financial risks with recommended mitigation strategies.
• Perform additional departmental initiatives and responsibilities as assigned.

Minimum Qualifications

• Associate degree with 3 or more years of experience in healthcare revenue cycle operations; or High school diploma with 5 or more years of experience in healthcare revenue cycle operations.

Preferred Qualifications

• 5 or more years of experience in healthcare revenue cycle operations, including insurance claims processing, reimbursement, collections, or accounts receivable management.
• 3 or more years of experience managing insurance claim denials, appeals, underpayments, and reimbursement recovery activities.
• 2 or more years of people leadership experience with responsibility for employee coaching, performance management, workload distribution, staffing oversight, and employee development.
• Experience working with Medicare, Medicaid, commercial payors, insurance claim adjudication processes, appeal submissions, and reimbursement workflows.
• Experience using revenue cycle management systems, billing platforms, reporting tools, and Microsoft Office applications.
• 3 or more years of leadership experience managing healthcare revenue cycle, denial management, appeals, billing, or reimbursement teams.
• 3 or more years of experience with medical billing, insurance claims processing, and Explanation of Benefits (EOB) review activities.
• 2 or more years of experience using XIFIN RPM and XIFIN Business Intelligence reporting tools.
• 2 or more years of experience supporting reimbursement activities for genetic testing, molecular testing, oncology testing, or specialty laboratory services.
• Experience supporting Medicare, Medicaid, and commercial payor reimbursement for laboratory testing services.
• Experience leading revenue cycle process improvement initiatives, system implementations, workflow redesign projects, or change management programs.
• Experience supporting Labcorp Genetics and/or Labcorp Oncology billing and reimbursement operations.

Additional Job Standards

• Demonstrated leadership practices involving coaching, delegation, conflict resolution, performance discussions, and employee development.
• Knowledge of denial management methodologies, appeals processes, payor requirements, reimbursement methodologies, and healthcare revenue cycle practices.
• Knowledge of operational and financial performance metrics, denial trend analysis, and root cause investigation techniques.
• Effective verbal, written, and presentation communication with employees, leadership teams, providers, clients, payors, and cross-functional stakeholders.
• Sound judgment when addressing employee matters, operational risks, compliance concerns, and business decisions.
• Project management and organizational skills for managing multiple priorities in a fast-paced environment.
• Focus on accuracy, quality, compliance, customer experience, and financial performance outcomes.
• Experience working collaboratively across operational, clinical, compliance, and technology teams.
• Commitment to fostering an inclusive, accountable, service-oriented, and continuous improvement culture.