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 ...
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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 ...
Epic Denials Manager
Detroit, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Detroit, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Grand Rapids, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Grand Rapids, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Lansing, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Lansing, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Midland, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
Epic Denials Manager
Midland, MI · Remote
Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... Collaborates closely with client managers and directors to ensure continuous open communication ...
... 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. ...
... 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 ...
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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 ...
Requirements: Duties and Responsibilities Team Management and Development * Knows, understands ... Director of Coding. * Partners with Clinical Documentation Integrity (CDI) staff to resolve ...
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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 ...
Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE
Grand Rapids, MI · On-site
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE
Grand Rapids, MI · On-site
... Director, or Utilization Review physician * Experience with: * Clinical Documentation Integrity (CDI) * Utilization Management * Revenue cycle operations * Denials management * Length of stay ...
This role carries direct responsibility for post-billed denials, including clinical denials, and ... This role partners closely with the Manager to coach staff, support onboarding and training, track ...
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This role carries direct responsibility for post-billed denials, including clinical denials, and ... This role partners closely with the Manager to coach staff, support onboarding and training, track ...
Coding Denials Resolution Specialist
Farmington Hills, 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 ...
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Coding Denials Resolution Specialist
Farmington Hills, 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 ...
... in denials management which include review of previous clinical decisions by Priority Health ... Directors (appeals). There will be opportunities to clinically contribute to discussions specific ...
... in denials management which include review of previous clinical decisions by Priority Health ... Directors (appeals). There will be opportunities to clinically contribute to discussions specific ...
Medical Director - Priority Health
Grand Rapids, MI · On-site +1
... in denials management which include review of previous clinical decisions by Priority Health ... Directors (appeals). There will be opportunities to clinically contribute to discussions specific ...
Medical Director - Priority Health
Grand Rapids, MI · On-site +1
... in denials management which include review of previous clinical decisions by Priority Health ... Directors (appeals). There will be opportunities to clinically contribute to discussions specific ...
Business Analyst - Patient Financial Experience * Days (M-F , 8a-5p) - 40hrs/wk
Wyoming, MI · On-site
Categorizes denials based upon root cause findings and distributes reports to applicable management ... procedures, pursuing self-directed learning and continuing education opportunities, and ...
Business Analyst - Patient Financial Experience * Days (M-F , 8a-5p) - 40hrs/wk
Wyoming, MI · On-site
Categorizes denials based upon root cause findings and distributes reports to applicable management ... procedures, pursuing self-directed learning and continuing education opportunities, and ...
Director Case Management
Detroit, MI · On-site
$120 - $160/hr
Onsite The Director Case Management is responsible for overseeing utilization management ... Monitor payer communications, authorizations, denials, and peer-to-peer review processes * Analyze ...
Director Case Management
Detroit, MI · On-site
$120 - $160/hr
Onsite The Director Case Management is responsible for overseeing utilization management ... Monitor payer communications, authorizations, denials, and peer-to-peer review processes * Analyze ...
Director Case Management
Detroit, MI · On-site
Onsite The Director Case Management is responsible for overseeing utilization management ... Monitor payer communications, authorizations, denials, and peer-to-peer review processes * Analyze ...
Quick apply
Director Case Management
Detroit, MI · On-site
Onsite The Director Case Management is responsible for overseeing utilization management ... Monitor payer communications, authorizations, denials, and peer-to-peer review processes * Analyze ...
Director Denials Management information
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 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 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 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:
- Director Revenue Cycle Operations
- Director Of Revenue Cycle
- Director Payment Integrity
- Remote Director Of Revenue Cycle Management
- Senior Revenue Manager
- Director Medicare Operations
- Remote Revenue Cycle Management From Home
- Per Diem Epic Revenue Cycle
- Assistant Director Revenue Cycle
- Executive Msn Leadership
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