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Job Description
Job Id:
319
# of Openings:
1
Job Title: Director, Denial Management & Follow-Up
Department: Revenue Cycle / Central Business Office
Reports To: Executive Director, CBO Revenue Cycle
Location: MedSrv Remote
Status: Full-Time / Exempt
Department: Revenue Cycle / Central Business Office
Reports To: Executive Director, CBO Revenue Cycle
Location: MedSrv Remote
Status: Full-Time / Exempt
Position Summary:
The Director of Denial Management & Follow-Up is a senior leadership role responsible for overseeing the strategic direction, operational execution, and performance optimization of denial management and accounts receivable follow-up functions. This position is instrumental in driving revenue integrity, reducing avoidable denials, and ensuring timely and accurate reimbursement from payers.
Key Responsibilities:
Leadership & Strategy:
- Develop and execute initiatives to reduce denial rates, improve claim resolution timelines, and maximize reimbursement.
- Collaborate with clinical, coding, billing, and compliance teams to ensure accurate documentation and clean claim submission.
- Lead the response to payer audits and appeals, ensuring timely, compliant, and effective resolution.
- Serve as a key liaison with payer representatives to resolve systemic issues and negotiate favorable outcomes.
- Establish and monitor performance metrics, including denial trends, days in AR, cash collections, and net revenue impact.
Process Improvement & Compliance
- Ensure compliance with federal, state, and payer-specific billing and reimbursement regulations.
- Drive continuous improvement through process redesign, automation, and adoption of advanced analytics tools.
- Collaborate with compliance and audit teams to ensure adherence to HIPAA and other regulatory standards.
Team Leadership & Development:
- Recruit, mentor, and develop high-performing teams, fostering a culture of accountability, collaboration, and excellence.
- Supervise AR managers and staff; provide coaching, training, and performance evaluations.
- Foster a culture of accountability, collaboration, and professional growth.
Qualifications:
- Bachelor’s degree in healthcare administration, Business Administration, Finance, or a related field is required or job-related experience.
- Equivalent combination of education and experience may be considered.
Skills & Competencies:
- Knowledge of Medicare, Medicaid, and commercial payer policies and reimbursement structures.
- Strong analytical and problem-solving skills
- Excellent communication and leadership abilities
- Proficiency in data analysis and reporting tools
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