BCRC Recovery Manager

Our subsidiary supports the Medicare Division by determining Medicare's responsibility for claims involving other parties. This area works to recover mistaken payments in accordance with Medicare Secondary Payer laws. BCRC works closely with attorneys, beneficiaries, other entities, and other insurance companies to ensure that claims are paid correctly under the guidelines established by Centers for Medicare and Medicaid Services (CMS).

• Manages the MSP Recovery team to ensure customer satisfaction and quality; ensures that employees adhere to departmental procedures, policies, workflow, and system processes
• Inventory Management:
  • Make daily decisions regarding workflow and sets goals and priorities to ensure work consistently meets established expectations and guidelines
  • Monitor daily processing/production reports to ensure correspondence are processed within the required timeframe and assigned to Specialists accordingly
  • Monitors team productivity to ensure objectives and standards are met; analyzes production reports and make recommendations to improve the department's efficiency rating
• Analyze weekly production and staff allocation reports to identify strengths and areas for improvement; analyze processes and results in order to improve departmental efficiencies
• Plans, organizes, and directs the workload based on Standard Operating Procedures (SOPs) to ensure compliance with corporate, and the CMS guidelines
• Budget, prioritize and monitor the BCRC department's activities and funds; review budget reports; forecast monthly contractual expenses and reconcile monthly invoices
• Selects, develops, counsels, evaluates and rewards associates' performance within CMS, corporate, and departmental policies and guidelines; supervises employees with respect to time and attendance; performance feedback and evaluation; coaching and discipline process
• Accountable for prioritizing responsibilities and workflow, addressing personnel issues and problems, short and long range planning, scheduling employees' time off requests, while ensuring adequate resources are available to meet productivity expectations at all times, and interfacing with other staff and management to resolve work related problems
• Accomplishes all assigned job functions in a manner that optimizes departmental effectiveness while maintaining confidentiality

• High School Diploma or equivalent
• Bachelor's Degree
• Broad knowledge of Medicare regulations and claims processing procedures, with an emphasis on secondary payer guidelines
• Knowledge of basic accounting principles in order to either coordinate or oversee the completion of accurate financial reports
• Analytical skills to interpret legal documents, analyze issues and provide resolutions
• Experience organizing, planning and directing associates reporting to them
• Experience budgeting, prioritizing and monitoring workload activities and funds, and reviewing budget reports, and forecasting monthly contractual expenses and reconciling monthly invoices
• Excellent written communication, oral and presentation skills
• Proven time management skills to multi-task in a high pressure, dynamic environment
• Experience identifying trends and making recommendations for process improvement
• Experience working in a successful team environment, providing helpful input
• Strong organizational skills and attention to detail
• Previous management experience preferred
• Prior work experience as pre-demand, post-demand or team lead position preferred
• Experience interpreting Medicare and Medicare Secondary Payer (MSP) guidelines and regulations consistently preferred
• General understanding of federal, state and local insurance law preferred
• Customer service experience gained by responding to written and verbal communication with customers preferred
• Knowledge of medical terminology, and ICD-9 and ICD-10 coding preferred
• Medicare Secondary Payer (MSP)/subrogation recovery process knowledge and/or familiarity with recovery systems (BCRS, HIGLAS) preferred

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