Manager, Denials/Appeals/Recovery

About the role

This leader has accountability and oversight, and supervises the daily activities of the Denials, Appeals, and Recovery department. In this role, the leader sets the tone and models positive leadership behavior, while ensuring individual and teamwork tasks, projects, and responsibilities are completed successfully in support of departmental, organizational goals.

Responsibilities

• Sets the tone and models positive leadership behavior
• Supervises the daily activities of the Denials, Appeals, and Recovery department
• Ensures individual and teamwork tasks, projects, and responsibilities are completed successfully
• Supports departmental, organizational goals

Requirements

• Bachelor’s degree required
• Relevant work experience can substitute on a year-for-year basis for the required degree
• Minimum of ten (10) years of managed care, appeals/denials and/or reimbursement schedules experience, in which, five (5) years are in written appeals
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification by the American Health Information Management Association (AHIMA)

Preferred Qualifications

• Knowledge of Medicare National Coverage Determinations (NCD) and Local Coverage Determination (LCD) protocols for medical necessity/Advanced Beneficiary Notice (ABN)
• Demonstrated leadership skills and understanding of group processes, teamwork, and cost center based management
• Demonstrated knowledge of International Classification Determination Tenth Revision (ICD-10), Current Procedural Terminology (CPT), Diagnosis-Related Groups (DRG), Healthcare Common Procedural Coding System (HCPCS), and Revenue codes
• Demonstrated ability in establishing and maintaining effective working relationships
• Demonstrated ability to analyze problems and consistently follow through to solution
• Demonstrated ability to take initiative and exercise independent judgment, decision-making, and problem solving expertise
• Demonstrated effective oral and written communication skills at all levels

Benefits

• Total Rewards Package
• Paid Time Off (start earning PTO on day one of employment)
• Tuition Reimbursement
• Discounted Medical, Prescription, Dental, Vision Benefit Plans for Full & Part-Time Employees
• Flexible Spending Accounts (Health Care and Dependent Care) - Pre-Tax Dollars
• Life Insurance
• Competitive rates Bonuses offered
• Disability Insurance
• Retail Savings Plan: 403b

Pay

Commensurate with experience

Schedule

Monday through Friday