What are the responsibilities and job description for the Manager, Denials position at St. Joseph's/Candler?
Position Summary
The Denials Manager for Hospital Revenue Cycle’s primary responsibilities are to identify, analyze, and address all denial and variance trends within the hospital revenue cycle space. This position will coordinate meetings within and outside of the department to discuss and problem solve denial issues. The Denials Manager will work closely with the hospital revenue cycle management team to develop process improvements to prevent denials from occurring and ensuring variances (underpayments) are appealed/paid appropriately. This position will be responsible for help building, implementing and operationalizing an internal variance workflow team. This position will also be responsible for coordinating outside of the department with hospital operation teams in order to prevent denial trends related, but not limited to, inappropriate diagnosis, medical necessity and other denial subtypes. This position will lead denial management meetings, strategy sessions and reporting to drive process improvement to generate high cash collections and less write-offs. Denials Manager will coordinate with the training team to coordinate any necessary training as a result of identifying denial trends. This position will be responsible for communicating all barriers, issues, trends, and progress to the Director of Patient Financial Services.
Education
Bachelors - Preferred
Experience
3-5 Years Management - Required
License & Certification
None Required
Core Job Functions
Maintains current knowledge of hospital, state and federal regulations and contractual agreements governing the fiscal aspects of the organization. Demonstrates commitment to personal professional growth through the pursuit of advanced knowledge and skills. Coordinates special projects and assists in program development as indicated and/or directed by the Director.
Performs personnel tasks including hiring, counseling, promoting and discipline staff with guidelines set by human resources. Completes evaluations and competencies in a fair and timely manner. Assures employee orientation and in-service education program and outside conferences.
Streamlines and standardizes the front desk operations in order to reduce denials based on registration, authorizations, and insurance verification errors.
Determines amount to collect from each patient on daily schedules and communicate to front desk. Coaches front desk staff on best techniques for collecting. Monitors statistical measures of success.
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