MANAGER-DENIAL

US-TN-MEMPHIS
2 weeks ago(1/3/2018 10:09 AM)
Position Code
10010691
Day Shift
Yes
Night Shift
No
Rotating Shift
No
Evenings
No
Status
Regular Full-Time
Department
HS DENIAL MITIGATION

Overview and Responsibilities

Purpose of Position and Scope of Responsibility:

 

The Denials Mitigation Manager manages the daily operations of the Denials Mitigation team to ensure that denials are addressed in a timely manner and in accordance with BMHCC and/or the payer’s policies and procedures. The manager has a thorough understanding of Baptist’s Revenue and Reimbursement Cycle, payer contractual guidelines, billing procedures, including the billing software system.  The manager will be responsible for analyzing and interpreting trends associated with denials and appeals to effectively manage reimbursement, and build strategies for mitigating future denials. This role will develop training and tools to support the denials and appeals management processes. The manager has a clear and functional understanding and the ability to troubleshoot the roles supported.  Responsible for assuring compliance with all local, state and federal regulations,.   Incumbent is accountable for these functions 24 hours per day, 7 days per week.  This position is under the general direction of the System Director, Clinical Documentation Integrity  #CB

Qualifications

                                                                                                         Minimum Qualifications

 

Knowledge/Education                                                   Bachelor's degree in healthcare, business administration, or Nursing                                                               

 

 

Experience    

 

Three to five years management experience required; financial analysis, denial management, contract management, or financial services experience preferred

                                                                                    

                                                                                     Basic understanding of Revenue Cycle functions, flow, and operations strongly preferred.

 

Licensure, Registration, Certification:                       RN preferred,  not required

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