Senior Manager, Revenue Cycle Operations

Job Description: As a Senior Manager in Healthcare Revenue Cycle Management, you will be responsible for leading a team of specialists in analyzing, resolving, and preventing claim denials. Your expertise will directly contribute to improved revenue integrity and financial performance for our clients.

Key Responsibilities:

1. Develop, implement, and manage effective denials management programs in collaboration with clients.
2. Direct a team in the analysis of denied claims, pinpointing root causes such as coding, billing, or authorization errors.
3. Work closely with clients' internal teams to address and resolve systematic issues contributing to denials.
4. Utilize analytics tools to track denial trends, measure performance, identify areas for improvement, and inform decision-making.
5. Develop and implement strategies to reduce denials and maximize clean claim submissions.

1. Lead, mentor, and develop a team of denials management specialists, fostering a focus on exceptional results and client satisfaction.
2. Collaborate with payers to understand denial trends, prioritize resolution of complex claims, and develop proactive solutions.
3. Stay up-to-date on regulatory changes and industry best practices, sharing knowledge across the team to ensure efficiency and compliance.
4. Provide regular reporting to internal leadership detailing denials management activities and key metrics.

1. Support business development initiatives by identifying and pursuing opportunities to expand our denials management services for existing clients
2. Contribute to the development of proposals, client presentations, and value-based analyses showcasing our expertise

1. Promote a collaborative and results-oriented team environment.
2. 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.

Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.