Enterprise Tech Denial Assistant Manager Enterprise Denials Days Full-Time

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Job description

Overview:
Serves as the dynamic technical denial assistant manager to maintain a low denial rate and high reimbursement rate at an enterprise level. Assumes responsibility and accountability for managing the denials for payers. This includes overseeing the daily operations of the denial process used and continually working to identify opportunities for workflow improvements. Responsible for setting departmental goals, measure process effectiveness and productivity, and identify any need for updated policy and procedures. Organizes and plans projects to improve effectiveness of billing, reimbursement rates, and appeal turnover rates. Performs analysis for denial trend improvement to include EPIC system edits, coding validation, CDM processes that affect reimbursement, authorization trends and performance improvement, and payer denial trends. Works in collaboration with the Enterprise Clinical Denial Assistant manager to educate departments on appropriate charging/billing/coding issues to ensure regulatory compliance. Works with managed care and compliance to resolve issues with departments and payers. Reports to the Enterprise Senior Denial Manager and serves as support to revenue cycle including clinical departments, patient financial services, revenue integrity, managed care, and leads the technical denial team.

Qualifications:
Minimum Education and Experience Requirements:

High school graduate required and minimum 3 years insurance/denial experience, and 3 years management experience.
Prefer Associates degree or higher in a health or business-related field and 3 years coding or 3 years insurance/ denial experience and 3 years management experience.

Knowledge, Skills, Abilities:
Demonstrated knowledge of:
oHospital billing and reimbursement
oDenials and appeals
oThird-party contracts
oInsurance protocols, delay tactics, systems, and workflows
o Federal and state regulations governing the healthcare industry
Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change.
Possesses efficient time-management skills and proven ability to multitask under tight deadlines
Demonstrates excellent leadership, conflict-resolution, and customer service skills
Exceptional writing and communications skills
Strong comfort level with computer systems and all Microsoft Office Products (Word, Excel, Outlook, PowerPoint)

Motor Vehicle Operator Designation:

Will not operate vehicles for an assigned business purpose

Licensure/Certification/Registration:

None

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