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Contractual Denial Management Jobs (NOW HIRING)

LA Health Solutions

Medical Billing Specialist

Metairie, LA · On-site

$16.50 - $21.25/hr

Denial Management & AR Follow-Up * Work denied, rejected, and underpaid claims promptly ... Identify underpayments, payer discrepancies, and contractual variances. * Assist with credit ...

Plutus Health

Sr. Sales Executive

Dallas, TX · On-site

We handle everything from medical coding and credentialing to denial management and patient ... WFO Terms-Fulltime/Part time/Contractual: Full-time Job Summary As a Senior Sales Executive, your ...

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Front Office Manager--Physical Therapy

Genesis Orthopedics & Sports Medicine

Saint Charles, IL

Full-time

Posted 4 days ago

Job description

Front Office Manager--Physical Therapy

Hybrid/Full-time

Join Our Mission at Genesis Orthopedics & Sports Medicine!

At Genesis Orthopedics & Sports Medicine, we believe high-quality orthopedic care should be accessible to all-not just those who can afford it. After 17 years of conventional practice, we took a step back, challenged the status quo, and reimagined healthcare delivery. Over four years, through hundreds of hours of research, global case studies, and bold innovation, we developed a new model that maintains our reputation for exceptional care while making our services more ethical and affordable.

Key Responsibilities 

  • Operations & Oversight
    • Daily Oversight of all administrative and front desk tasking for 6 outpatient Physical Therapy clinics
    • Review and validate all contractual adjustments and ensure accuracy in claim posting and payer compliance.
    • Download and allocate new accounts to analysts from multiple EPIC workqueues based on payer, aging, and priority.
    • Audit processed claims for accuracy, completeness, and timeliness before submission or follow-up.
    • Perform quality checks and ensure analysts follow correct claim handling procedures.
    • Conduct daily and weekly performance reviews, tracking productivity and accuracy metrics.
  • Team Management
    • Lead and support a team of claims analysts, providing guidance, performance feedback, and escalation support.
    • Review and summarize EOD (End of Day) and EOW (End of Week) reports to evaluate team output and resolve discrepancies.
    • Manage task assignments, track turnaround times, and balance workloads across analysts.
    • Provide training and corrective coaching when errors or trends are identified.
  • Claims & Denial Management
    • Oversee denial trending and root cause analysis for all orthopedic-related claims.
    • Identify and escalate systemic issues such as incorrect coding, missing documentation, or payer configuration errors.
    • Work closely with billing, coding, and authorization teams to resolve high-value or high-impact claims.
    • Ensure claims are submitted, followed up, and appealed in accordance with payer guidelines and timely filing limits.
  • Analytics & Reporting
    • Prepare and distribute daily, weekly, and monthly reports on claim status, denial trends, and AR performance.
    • Monitor KPIs such as denial rate, claim turnaround time, and first-pass resolution rate.
    • Track performance metrics for the entire team and provide data-driven recommendations for improvement.
  • Compliance & Continuous Improvement
    • Ensure all claim activities comply with HIPAA, payer rules, and internal SOPs.
    • Stay current with orthopedic coding changes, payer updates, and EPIC workflows.
    • Recommend and implement process improvements to enhance claim accuracy and reduce rework.
    • Participate in audits and provide supporting claim documentation when required.

Requirements

Qualifications

  • 3-5 years of experience in medical claims management or billing, with a strong focus on orthopedic claims.
  • Proven experience managing or leading a claims or AR team in a healthcare setting.
  • Hands-on experience with EPIC system is required.
  • Excellent understanding of CPT/HCPCS codes, modifiers, EOBs, ERAs, CARC/RARC codes, and payer-specific denial handling.
  • Advanced Excel skills (pivot tables, lookups, trend tracking).
  • Exceptional attention to detail and strong problem-solving abilities.
  • Excellent communication skills and ability to work cross-functionally with billing, coding, and management teams.

Benefits

Why Choose Genesis?

Supportive Team - Be part of a compassionate and professional healthcare team that values collaboration.

Competitive Compensation - Enjoy a strong base salary with opportunities for performance-based bonuses.

Meaningful Impact - Help us revolutionize healthcare by making top-tier orthopedic care accessible to everyone.

Apply today and be part of something truly transformative at Genesis Orthopedics & Sports Medicine.

Apply