Denials Manager

American Family Care
Birmingham, AL

Job Description

Job Description

Summary

Job Requirements

  • Examine denials data to identify trends and potential denials initiatives
  • Monitor identified denials trends and select top initiatives to prioritize
  • Work with RCM functional leaders to perform account sampling and document observations
  • Formulate initial hypothesis for root cause and potential resolution steps
  • Discuss findings with Denial Management team and RCM functional leaders to validate trends in denial root causes
  • Lead weekly meetings to introduce new initiatives and review status of ongoing initiatives
  • Assing action items to specific team members/state holders
  • Follow-up with action item owners between formal meetings
  • Oversee the process of appealing denied claims, ensuring timely and accurate submissions
  • Establish a feedback loop with BPO vendor and RCM functional leaders to drive process improvements and minimize errors
  • Other duties as assigned
  • BA degree in related field preferred
  • Minimum 5 years healthcare leadership experience in RCM environments
  • Ability to travel
Physical Demands/Work Environment (optional)

Office environment. Sitting and keyboarding for extended periods of time. Frequent telephone use. High attention to detail and ability to focus. Moderate noise level.

This is a remote position.

Posted 2025-09-25

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