Senior Manager, Revenue Cycle Operations

Key Responsibilities

• Service Delivery
• Develop, implement, and manage effective denials management programs in collaboration with clients.
• Direct a team in the analysis of denied claims, pinpointing root causes such as coding, billing, or authorization errors.
• Closely work with clients' internal teams to address and resolve systematic issues contributing to denials.
• Utilize analytics tools to track denial trends, measure performance, identify areas for improvement, and inform decision-making.
• Develop and implement strategies to reduce denials and maximize clean claim submissions.
• Leadership
• Lead, mentor, and develop a team of denials management specialists, fostering a focus on exceptional results and client satisfaction.
• Collaborate with payers to understand denial trends, prioritize resolution of complex claims, and develop proactive solutions.
• Stay up-to-date on regulatory changes and industry best practices, sharing knowledge across the team to ensure efficiency and compliance.
• Provide regular reporting to internal leadership detailing denials management activities and key metrics.
• Business Development
• Support business development initiatives by identifying and pursuing opportunities to expand our denials management services for existing clients.
• Contribute to the development of proposals, client presentations, and value-based analyses showcasing our expertise.
• Culture
• Promote a collaborative and results-oriented team environment.
• Champion continuous process improvement initiatives, streamlining workflows, and enhancing overall efficiency within the denials management function.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
• Minimum of 5-8 years of experience in healthcare revenue cycle management, with direct experience in denials management.
• Proven success in reducing denials and improving revenue cycle performance.
• Expertise in healthcare coding, billing, and reimbursement regulations.
• Excellent analytical, problem-solving, and communication skills.
• Demonstrated ability to lead, motivate, and develop teams.