Denials Manager

Job Description

Job Description

Summary

Job Requirements

• Examine denials data to identify trends and potential denials initiatives
• Monitor identified denials trends and select top initiatives to prioritize
• Work with RCM functional leaders to perform account sampling and document observations
• Formulate initial hypothesis for root cause and potential resolution steps
• Discuss findings with Denial Management team and RCM functional leaders to validate trends in denial root causes
• Lead weekly meetings to introduce new initiatives and review status of ongoing initiatives
• Assing action items to specific team members / state holders
• Follow-up with action item owners between formal meetings
• Oversee the process of appealing denied claims, ensuring timely and accurate submissions
• Establish a feedback loop with BPO vendor and RCM functional leaders to drive process improvements and minimize errors
• Other duties as assigned
• BA degree in related field preferred
• Minimum 5 years healthcare leadership experience in RCM environments
• Ability to travel

Physical Demands / Work Environment (optional)

Office environment. Sitting and keyboarding for extended periods of time. Frequent telephone use. High attention to detail and ability to focus. Moderate noise level.

This is a remote position.