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Denials Manager Jobs in Georgia (NOW HIRING)

Manages claims, as well as claims staff, in other areas, including Miscellaneous Professional ... and denials but obtain appropriate authority to issue denials. Provide timely and accurate ...

Payment Poster

Richmond Hill, GA · On-site

$15 - $18.75/hr

Billing Manager Department: Revenue Cycle Job Summary: The Payment Poster is responsible for accurately posting payments, adjustments, and denials to patient accounts in the practice management ...

Coding Payment Resolution Spec

Rex, GA · On-site

$17.25 - $22.25/hr

Coding Payment Resolution Specialist Responsible for reviewing all post-billed denials (inclusive ... company, managed care organization or other health care financial service setting, performing ...

... denials, and releasing encounters for billing. Utilizes intermediate problem-solving skills to ... Evaluation & Management (E/M) services * Diagnostic and procedural services * Facility or ...

Showing results 41-60

Denials Manager information

What is a denials manager?

A Denials Manager is a healthcare professional responsible for overseeing and managing the process of claim denials from insurance companies. Their primary role is to identify the causes of denied claims, implement strategies to reduce future denials, and ensure timely resolution and appeal of denied claims to maximize revenue for healthcare organizations. Denials Managers often collaborate with billing, coding, and clinical staff to ensure compliance with payer requirements and improve the overall reimbursement process. They play a crucial role in maintaining the financial health of medical practices or hospitals by minimizing lost revenue due to claim denials.

What are the key skills and qualifications needed to thrive as a denials manager?

To thrive as a Denials Manager, you need a deep understanding of medical billing, coding, insurance processes, and healthcare regulations, usually supported by a degree in healthcare administration or a related field. Familiarity with revenue cycle management systems, electronic health records (EHRs), and data analytics tools is essential, and certification like Certified Revenue Cycle Representative (CRCR) can be advantageous. Strong analytical thinking, problem-solving, and communication skills help in effectively leading teams and negotiating appeals with payers. These skills are critical for minimizing revenue loss, ensuring compliance, and optimizing reimbursement processes within healthcare organizations.

What are some common challenges faced by denials managers, and how can they effectively address them?

Denials Managers often encounter challenges such as identifying root causes of claim denials, staying updated with changing payer policies, and coordinating between billing, coding, and clinical teams. To address these challenges, Denials Managers typically implement robust tracking systems, conduct regular staff training, and foster open communication across departments. Proactively analyzing denial trends and collaborating on process improvements are key strategies to reduce future denials and enhance overall revenue cycle performance.

What is the difference between Denials Manager vs Claims Supervisor?

AspectDenials ManagerClaims Supervisor
CredentialsTypically requires healthcare administration, billing, or coding certificationsOften requires similar certifications, with additional supervisory or management training
Work EnvironmentManages denial appeals, reviews claim rejections, collaborates with billing and coding teamsOversees claims processing, supervises claims staff, ensures compliance with policies
Industry UsageCommon in healthcare, insurance, and hospital settingsCommon in healthcare organizations, insurance companies, and billing departments

While both roles focus on claims processing, the Denials Manager specializes in managing claim denials and appeals, whereas the Claims Supervisor oversees the entire claims process and staff. Both positions require healthcare billing knowledge and certification, but their primary responsibilities differ in scope and focus.

What are the most commonly searched types of Denials jobs in Georgia?

The most popular types of Denials jobs in Georgia are:

What cities in Georgia are hiring for Denials Manager jobs?

Cities in Georgia with the most Denials Manager job openings:

Revenue Cycle Trainer (Front Office) Leadership and classroom training experience required

Northside Hospital Inc.

Atlanta, GA • On-site

Full-time

Re-posted 6 days ago


Northside Hospital rating

7.2

Company rating: 7.2 out of 10

Based on 442 frontline employees who took The Breakroom Quiz

349th of 888 rated healthcare providers


Job description

Overview
Develops professional, creative, and engaging training content materials for Registration, both hospital based and/or practice-based, all functional areas of the Business Office, and Physician Office practices based on most current knowledge of widely accepted best practices for adult learning and job training.
Conducts online learning courses, classroom training, in-service training, post-training job performance assessments, and focused re-training of employees.
Demonstrates professional leadership skills in verbal, written, and interpersonal communications and relationships.
Works autonomously to manage assigned projects, tasks, team functions, training courses scheduled to complete desired outcome in required timeframe, using appropriate judgment and decision making and demonstrating resourcefulness.
Functional areas supported: Pre-registration, Registration (Hospital, Outpatient Centers, Physician Practices), Financial Counseling, PBX, Room Control, Denials Management, Audit, Commercial Collections, Customer Service, Commercial Reimbursement, Self Pay Collections, Insurance Verifications, Financial Assistance, and any other Revenue Cycle functions.
Responsibilities
Conducts structured observation sessions to learn business processes to document, analyze and structure training products in a manner that best supports the learner, including the full range of learning styles and pace.
Develops professional, creative, engaging, and effective training content using Articulate applications, MS Office (PowerPoint, Word, Excel), and other interactive computer based learning software as may be prescribed by team leadership.
Manages student information in Northside Hospital's Learning Management system, including class enrollments, quarterly class entry and maintenance, student class attendance, monitoring of online learning course completion, and class grades.
Establishes initial system access for the majority of systems used by Registration team members.
Acts as the communication hub for insurance plan/provider updates and process and system changes by providing communication to team members, specialized online training, and maintaining current information in shared online folders and by maintaining the Revenue Cycle website.
Conducts online learning courses, classroom training, and in-service training for Registration (Hospital, Outpatient Centers, Physician Practices), Financial Counseling, Room Control, and all functional areas of the Business Office.
Conducts post training job performance assessment and focused retraining of employees for Registration (Hospital, Physician Practices), Financial Counseling, Room Control, all functional areas of the Business Office/Physician Billing Services.
Participates in system implementations and upgrades by developing test scripts for unit testing and integrated testing and by actively participating in unit testing and integrated testing with Information Systems.
Qualifications
REQUIRED
High School diploma or equivalent and two (2) years of healthcare revenue cycle leadership experience in area relevant to assigned area (Patient Access, Physician Practice, Outpatient Facility, or Business Office)
OR
Associate's degree in Business, Health Administration and one (1) year of healthcare revenue cycle leadership experience in area relevant to assigned area (Patient Access, Physician Practice, Outpatient Facility, or Business Office)
OR
Bachelor's degree in Business, Health Administration, or Education, or related field
PREFERRED
Bachelor Degree in Business Administration, Health Administration, Education or related field is strongly preferred.
Professional, structured training and education course development for revenue cycle training courses is strongly preferred.
*We do not consider onboarding/informational/side by side or 1 on 1 training as the type of training experience we are seeking.**
Functional knowledge of Cerner healthcare system.
CHAA (Certified Healthcare Access Associate), CPAR (Certified Patient Account Representative), CRCR (Certified Revenue Cycle Representative), or CHFP (Certified Healthcare Finance Professional).
Demonstrated excellent verbal, written, and interpersonal communication skills; must score in high range on pre-screening communication skills aptitude assessment.
Functional knowledge of healthcare revenue cycle systems.
Functional knowledge and skills in the use and of Microsoft Office Suite (Power Point, Word, Excel, and Outlook) or equivalent; must score in high range on pre-screening communication skills aptitude assessment.
Work Hours:
8AM-4:45PM
Weekend Requirements:
No
On-Call Requirements:
No

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About Northside Hospital

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* 288-bed hospital, offering a full range of services including comprehensive and interventional stroke care, preventative and corrective cardiac care, full-service orthopedic and spine treatment, an ER 24/7®, and general surgery * As one of the first hospitals in the area to achieve Atrial Fibrillation Certification (SCPC), our technologically advanced hospital allows our highly skilled physicians, nursing and caregivers to serve our growing community * Northside Hospital was the first nationally recognized Comprehensive Stroke Center in Pinellas County and nationally recognized for quality and safety by earning an 'A' rating from the Leapfrog Group

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Atlanta, GA, US

Year founded

1970