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Avp Denial Management Jobs (NOW HIRING)

Humana Inc

Use utilization, authorization, denial, appeal, claims, care management, quality, medical expense ... The AVP will be accountable for aligning cross-functional teams around shared goals for ...

Veradigm

RCM Sr Manager Client Executive

Raleigh, NC · On-site

... R aging, denial trends).Partner with AVP to resolve escalations and implement corrective actions ... Required Qualifications 12-15 years of progressive experience in Revenue Cycle Management ...

Veradigm

RCM Sr Manager Client Executive

Raleigh, NC · On-site

... R aging, denial trends).Partner with AVP to resolve escalations and implement corrective actions ... Required Qualifications12-15 years of progressive experience in Revenue Cycle Management, primarily ...

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Avp Denial Management information

What is an AVP Denial Management?

An AVP (Assistant Vice President) of Denial Management is a healthcare management professional responsible for overseeing the processes that handle insurance claim denials within a healthcare organization. Their role involves analyzing denial trends, developing strategies to reduce denials, leading denial management teams, and ensuring timely resolution of denied claims to optimize revenue cycle performance. They often collaborate with billing, coding, and compliance teams to improve accuracy and prevent future denials. Additionally, they implement best practices and monitor key performance indicators to enhance the overall financial health of the organization.

What are the key skills and qualifications needed to thrive as an AVP Denial Management?

To excel as an AVP Denial Management, you need expertise in healthcare revenue cycle management, strong analytical abilities, and a bachelor's or master's degree in healthcare administration or a related field. Familiarity with denial management software, claims processing systems, and data analytics tools is essential, along with certifications like Certified Revenue Cycle Representative (CRCR) or Certified Professional Coder (CPC). Exceptional leadership, communication, and problem-solving skills set standout professionals apart in this role. These competencies are crucial for efficiently reducing claim denials, optimizing revenue, and leading teams to improve organizational financial performance.

What are the typical challenges faced by an AVP Denial Management, and how can they address them effectively?

An AVP of Denial Management often faces challenges such as high volumes of claim denials, evolving payer requirements, and coordination across multiple departments. Addressing these challenges requires a strong understanding of revenue cycle processes, effective team leadership, and the ability to implement data-driven strategies for denial prevention and resolution. Building collaborative relationships with clinical, billing, and IT teams is crucial to streamline workflows and ensure timely reimbursement. Regular training and process audits also help in identifying trends and reducing future denials.

What is the difference between Avp Denial Management vs Denial Management Specialist?

AspectAvp Denial ManagementDenial Management Specialist
CredentialsTypically requires 8+ years of experience, bachelor's degree, and leadership skillsUsually requires 2-5 years of experience, relevant certifications, and specialized knowledge
Work EnvironmentSenior management, strategic planning, overseeing teamsOperational role, handling daily denial resolutions and claims processing
Employer & Industry UsageHealthcare organizations, insurance companies, hospital systemsHospitals, insurance providers, revenue cycle management firms

The Avp Denial Management typically holds a senior leadership role focused on strategic oversight and team management, requiring extensive experience. In contrast, a Denial Management Specialist handles day-to-day claim denials, focusing on operational tasks. Both roles are essential in healthcare revenue cycle management but differ significantly in scope and responsibilities.

What are popular job titles related to Avp Denial Management jobs?

For Avp Denial Management jobs, the most frequently searched job titles are:

Infographic showing various Avp Denial Management job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution.

AVP of Physician Revenue Operations

Brooklyn, NY • On-site

TAL Healthcare
Recruiting and Staffing Services • 11 - 50 employees
Learn more about TAL Healthcareexternal

$200K - $220K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

AVP Physician Revenue Operations

Job Description
Our client, a leading healthcare organization committed to clinical excellence and operational efficiency, is hiring a Vice President of Physician Revenue Operations. The AVP of Physician Revenue Operations is a critical leadership role responsible for overseeing the comprehensive financial functions related to physician practices and healthcare revenue cycles. Reporting directly to the Vice President, this position requires strategic oversight and collaborative management to optimize financial performance, improve operational efficiencies, and strengthen physician and client relations.
Responsibilities

· Financial Operations: Partner with management, physicians, and staff to identify and implement financial improvements, streamline business operations, optimize staffing models, and integrate new technologies to enhance cash flow and receivables management.

· Revenue Cycle Management: Lead the revenue cycle processes, ensuring accuracy and integrity in charge entry, coding, claims processing, cash posting, denial management, and third-party collections. Facilitate operational reviews and work closely with IT to maintain and optimize revenue cycle systems.

· Client Services and Physician Relations: Collaborate with clinical teams and physicians to assess operational and financial effectiveness, developing strategies for continuous improvement. Maintain effective communication channels and monitor key performance indicators (KPIs) to support practice success.

· Onboarding and Insurance Enrollment: Oversee physician onboarding and insurance enrollment activities, ensuring compliance with standards and regulations. Develop and train staff on credentialing and enrollment practices, maintaining database integrity.

· Project Management: Plan, execute, and monitor projects related to practice operations, communicating progress and mitigating risks. Track metrics and ensure project goals are achieved efficiently and effectively.

Requirements

· Minimum 10 years of experience in revenue cycle management, patient financial services, reimbursement, or related healthcare financial fields.

· Proven experience leading organizational transformation and process improvement initiatives.

· Bachelor's degree in Health Finance, Hospital Administration, or General Finance; Master’s degree preferred.

· Demonstrated proficiency in PowerPoint, Word, Excel, Outlook, and Teams, with the ability to prepare executive-level presentations.

· Exceptional communication, interpersonal, negotiation, and conflict management skills.

· Strong critical thinking, problem-solving abilities, and attention to detail.

· Experience building and maintaining effective physician relationships.

Company Description

We provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.