Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Denials Management Specialist
Shelby, MI · On-site
Position Summary: The Denials Management Specialist is responsible for timely and accurate ... from direct supervisor. Maintains required levels of productivity while managing tasks in work ...
Reporting to the Director of Denials Management, this role leads a team of denial specialists and coordinators focused on resolving technical and coding-related claim denials across all payer types ...
Quick apply
Reporting to the Director of Denials Management, this role leads a team of denial specialists and coordinators focused on resolving technical and coding-related claim denials across all payer types ...
... denials management, performance improvement, regulatory, compliance, and risk with an expectation ... Director Meetings (MDMs), and during Administrative Law Judge (ALJ) hearings for denied cases. 4. ...
... denials management, performance improvement, regulatory, compliance, and risk with an expectation ... Director Meetings (MDMs), and during Administrative Law Judge (ALJ) hearings for denied cases. 4. ...
We are seeking an operationally focused Director of Patient Financial Services (PFS) to lead ... Deep understanding of payer guidelines, claims processing, denials management, and revenue cycle ...
Quick apply
We are seeking an operationally focused Director of Patient Financial Services (PFS) to lead ... Deep understanding of payer guidelines, claims processing, denials management, and revenue cycle ...
... denials management, performance improvement, regulatory, compliance, and risk with an expectation ... Director Meetings (MDMs), and during Administrative Law Judge (ALJ) hearings for denied cases. 4. ...
... denials management, performance improvement, regulatory, compliance, and risk with an expectation ... Director Meetings (MDMs), and during Administrative Law Judge (ALJ) hearings for denied cases. 4. ...
Manager, Coding Denials
Farmington, MI · On-site
Requirements: Duties and Responsibilities Team Management and Development * Knows, understands ... Director of Coding. * Partners with Clinical Documentation Integrity (CDI) staff to resolve ...
Quick apply
Manager, Coding Denials
Farmington, MI · On-site
Requirements: Duties and Responsibilities Team Management and Development * Knows, understands ... Director of Coding. * Partners with Clinical Documentation Integrity (CDI) staff to resolve ...
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
Coding Denials Resolution Specialist
Farmington, MI · On-site
$18.50 - $23.50/hr
... as directed by supervisor. * Interprets data, draws conclusions, and reviews findings with all ... company, managed care organization, or other healthcare financial service setting, performing ...
Quick apply
Coding Denials Resolution Specialist
Farmington, MI · On-site
$18.50 - $23.50/hr
... as directed by supervisor. * Interprets data, draws conclusions, and reviews findings with all ... company, managed care organization, or other healthcare financial service setting, performing ...
Categorizes denials based upon root cause findings and distributes reports to applicable management ... procedures, pursuing self-directed learning and continuing education opportunities, and ...
Categorizes denials based upon root cause findings and distributes reports to applicable management ... procedures, pursuing self-directed learning and continuing education opportunities, and ...
... directed by the Supervisor Clinical / Coding Payment Resolution. * Interprets data, draws ... company, managed care organization or other health care financial service setting, performing ...
... directed by the Supervisor Clinical / Coding Payment Resolution. * Interprets data, draws ... company, managed care organization or other health care financial service setting, performing ...
RN CLINICAL MANAGER - UTILIZATION MANAGEMENT (UM)
Saginaw, MI · On-site
Medical
Dental
Vision
Retirement
PTO
The Manager provides input to the Director of Revenue Cycle regarding daily strategic decisions ... Resource to Billing / Denials Management as needed. Qualifications Bachelor's Degree required.
RN CLINICAL MANAGER - UTILIZATION MANAGEMENT (UM)
Saginaw, MI · On-site
Medical
Dental
Vision
Retirement
PTO
The Manager provides input to the Director of Revenue Cycle regarding daily strategic decisions ... Resource to Billing / Denials Management as needed. Qualifications Bachelor's Degree required.
... denials documented and followed up, and that transition planning assessments are completed timely. Utilization Management • Implements and monitors processes to ensure medical necessity review ...
... denials documented and followed up, and that transition planning assessments are completed timely. Utilization Management • Implements and monitors processes to ensure medical necessity review ...
Group Director - Utilization Review
Detroit, MI · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Group Director, Utilization Review will perform the functions necessary to support and advance ... utilization management supporting medical necessity and denials prevention. QUALIFICATIONS:
Group Director - Utilization Review
Detroit, MI · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Group Director, Utilization Review will perform the functions necessary to support and advance ... utilization management supporting medical necessity and denials prevention. QUALIFICATIONS:
Director Denials Management information
What is the difference between Director Denials Management vs Denials Management Specialist?
| Aspect | Director Denials Management | Denials Management Specialist |
|---|---|---|
| Credentials | Bachelor's degree, leadership experience | High school diploma or associate's, healthcare or insurance knowledge |
| Work Environment | Management, strategic planning, team oversight | Operational, claims review, denial resolution |
| Industry Usage | Healthcare, insurance companies, hospital systems | Healthcare providers, insurance payers, billing departments |
| Search/Comparison Intent | Leadership roles, strategic denial management | Operational roles, claims processing |
While both roles focus on managing claim denials, the Director Denials Management oversees teams and strategies, whereas the Denials Management Specialist handles day-to-day claim review and resolution tasks.
What are the primary challenges faced by a director denials management, and how can they address them effectively?
A Director of Denials Management often encounters challenges such as staying ahead of frequently changing payer regulations, identifying root causes of denials, and leading cross-departmental initiatives to improve claim approval rates. Success in this role requires strong analytical skills to interpret denial trends, effective communication to collaborate with clinical, coding, and billing teams, and the ability to implement process improvements. Addressing these challenges involves fostering a culture of accountability, providing ongoing staff education, and leveraging technology to streamline workflows and monitor performance metrics.
What does a director denials management do?
A Director of Denials Management is responsible for overseeing the strategies and processes that address insurance claim denials in a healthcare organization. They lead teams to analyze denial trends, develop solutions to reduce future denials, and work closely with billing, coding, and clinical staff to ensure accurate claims submission and appeals. Their role is crucial in optimizing revenue cycle performance and ensuring the organization receives appropriate reimbursement for services provided.
What are the key skills and qualifications needed to thrive as a director denials management?
To thrive as a Director of Denials Management, you need in-depth knowledge of healthcare revenue cycle management, denial prevention strategies, and a relevant degree in healthcare administration or business. Experience with claims management systems, EHRs, and analytics tools such as Epic, Cerner, or similar platforms is typically required. Strong leadership, problem-solving, and communication skills help drive team performance and facilitate cross-departmental collaboration. These skills are crucial for minimizing denials, optimizing reimbursement, and ensuring financial health for healthcare organizations.
What are the most commonly searched types of Denials Management jobs in Michigan?
The most popular types of Denials Management jobs in Michigan are:
What are popular job titles related to Director Denials Management jobs in Michigan?
For Director Denials Management jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Director Denials Management jobs in Michigan look for?
The top searched job categories for Director Denials Management jobs in Michigan are:
What cities in Michigan are hiring for Director Denials Management jobs?
Cities in Michigan with the most Director Denials Management job openings:
Job description
Position Summary:
The Denials Management Specialist is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The specialist will work independently while managing their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.
Essential Functions and Responsibilities as Assigned:
1. Monitors denial work queues and reports in accordance with assignments from direct supervisor. Maintains required levels of productivity while managing tasks in work queues to ensure timeliness of follow-up and appeals.
2. Tracks and investigates denial trends/ root cause.
3. Assists with claim audits as necessary.
4. Makes management aware of any issues or changes in the billing system, insurance carriers, and/or network.
5. Obtain retro authorizations and submit to payers for reimbursement.
6. Ability to write non-clinical appeals with demonstrating proficiency with timely and successful submissions.
7. As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or CBS management.
8. Works independently with other departments to resolve A/R and payer issues.
9. Participates in departmental and team meetings involving discussion of A/R processes and trends.
10. Knowledge of payer edits, rejections, rules, and how to appropriately respond to each to resolution.
Qualifications:
Required:
OR
The Denials Management Specialist is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The specialist will work independently while managing their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.
Essential Functions and Responsibilities as Assigned:
1. Monitors denial work queues and reports in accordance with assignments from direct supervisor. Maintains required levels of productivity while managing tasks in work queues to ensure timeliness of follow-up and appeals.
2. Tracks and investigates denial trends/ root cause.
3. Assists with claim audits as necessary.
4. Makes management aware of any issues or changes in the billing system, insurance carriers, and/or network.
5. Obtain retro authorizations and submit to payers for reimbursement.
6. Ability to write non-clinical appeals with demonstrating proficiency with timely and successful submissions.
7. As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or CBS management.
8. Works independently with other departments to resolve A/R and payer issues.
9. Participates in departmental and team meetings involving discussion of A/R processes and trends.
10. Knowledge of payer edits, rejections, rules, and how to appropriately respond to each to resolution.
Qualifications:
Required:
- High School Diploma or GED
- 7 years experience in Patient Accounting or Patient Access experience
OR
- Associates Degree with 3 years of Patient Accounting or Patient Access experience
About McLaren
Sourced by ZipRecruiter
McLaren Group is globally renowned as one of the world’s most illustrious high-technology brands. Since the formation of McLaren Racing in 1963, McLaren has been pioneering and innovating in the competitive world of Formula 1, forging a formidable reputation which has seen the racing team win 20 World Championships and over 180 races. The Group has built on its successful racing expertise and diversified to include a global, high-performance sports car business, McLaren Automotive, and a game-changing technology and innovation business, McLaren Applied. Despite the broadening of the group’s business interests, McLaren’s goal remains singular: we exist to win in everything we do.
Industry
Automobile dealers and manufacturing
Company size
10,000+ Employees
Headquarters location
Woking, Surrey, GB