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Manager, Payment Resolution, Acute Hospital Denials & Appeals - PFS (Remote)
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Full-time
Remote
- Manages and oversees a team responsible for all post billed denials (inclusive of clinical denials), ensuring payments are received on denied accounts, determining root causes of denials and preventing denials within the Hospital or Medical Group revenue operations of an assigned Patient Business Services (PBS) location spanning across multiple regions accounts receivable and payer environments.
- Manages and oversees day-to-day activities and responsibilities of the payment resolution/denials team handling the receipt, analysis, and appeals of denials received in order to achieve optimal area performance and colleague productivity goals as part of the revenue cycle process for an assigned PBS location.
- Assists the payment resolution denials in the development of broader goals and objectives based on PBS needs and ensures continuous improvement in quality, operational cost effectiveness, customer satisfaction and resource utilization.
- Manages continuous quality improvement initiatives across the denials team and other departments within the PBS to streamline processes.
- Maintains current knowledge of Medicare, Medi-Cal, Medicaid, and Managed Care billing compliance guidelines and requirements across multiple regions and states, as they pertain to charges, billing and coding.
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