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Denials Manager Jobs in Texas (NOW HIRING)

DHR Health

Clerk, Denials Management

Edinburg, TX · On-site

Provides secretarial and administrative support services to Denials Team. POSITION EDUCATION ... Management on status of appeals from Careport • Monitors & corrects any duplicate records in ...

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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 Texas?

The most popular types of Denials jobs in Texas are:

What are popular job titles related to Denials Manager jobs in Texas?

For Denials Manager jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Denials Manager jobs in Texas look for?

The top searched job categories for Denials Manager jobs in Texas are:

What cities in Texas are hiring for Denials Manager jobs?

Cities in Texas with the most Denials Manager job openings:

Denials Manager jobs near you

Revenue Cycle Clinical Denials Specialist

CornerStone Staffing

Fort Worth, TX • On-site

$35/hr

Full-time

Re-posted 7 days ago

Job description

Do you have experience with hospital revenue cycle, denials management, and insurance appeals?


Join one of Fort Worth's leading healthcare systems and put your clinical revenue cycle expertise to work!


Position: Revenue Cycle Clinical Denials Specialist

Location: Fort Worth, TX | Onsite

Pay: $35HR

Schedule: Monday - Friday | Business Hours

Status: Temp


Job Description:

The Revenue Cycle Clinical Denials Specialist plays a vital role in maximizing hospital reimbursement by researching, analyzing, and resolving complex clinical claim denials. This position is responsible for reviewing medical documentation, identifying root causes of denials, preparing detailed appeal letters, tracking denial trends, and collaborating with clinical and revenue cycle teams to improve reimbursement outcomes and prevent future denials.

Job Duties:

  • Investigate and resolve complex clinical insurance denials including medical necessity, authorization, referrals, level of care, and late notifications.
  • Review medical records, billing information, and clinical documentation to determine root causes of denied claims.
  • Prepare and submit detailed, well-supported appeal and reconsideration letters in accordance with CMS, Medicaid, and commercial insurance guidelines.
  • Monitor and trend denial activity, recoveries, and reimbursement outcomes.
  • Identify recurring denial patterns and recommend process improvements to reduce future denials.
  • Collaborate with clinical departments, physicians, and revenue cycle leadership to improve reimbursement performance.
  • Review payer policy updates and communicate reimbursement risks to leadership.
  • Maintain accurate documentation while ensuring compliance with regulatory and organizational standards.

A GREAT Candidate Will Have:

  • Minimum 3 years of recent hospital revenue cycle, medical billing, denials management, and insurance collections experience.
  • Experience writing insurance appeals and overturning clinical denials.
  • Strong understanding of CPT, HCPCS, ICD-10 coding, medical terminology, insurance billing, and reimbursement guidelines.
  • Knowledge of CMS, Medicaid, commercial payer policies, and hospital revenue cycle processes.
  • Advanced analytical, problem-solving, and root cause analysis skills.
  • Excellent written communication and professional business writing abilities.
  • Intermediate to advanced Microsoft Excel skills with experience analyzing denial data.
  • Prior Epic Resolute (Hospital Billing) experience is required.
  • LVN, CPC, CIC, COC, or CPB certification is highly preferred but not required.

Application Process Includes:

  • Background Check
  • Drug Screen
  • Skills Assessment
  • Flu shot/ Tb Test

LEGAL NOTICE

By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at: https://www.cornerstonestaffing.com/privacy

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