CBO Director of Denial Management & Follow-Up
Job Title: Director, Denial Management & Follow-Up
Department: Revenue Cycle / Central Business Office
Reports To: Executive Director, CBO Revenue Cycle
Location: MedSrv Remote
Status: Full-Time / Exempt
Position Summary:
The Director of Denial Management & Follow-Up is a senior leadership role responsible for overseeing the strategic direction, operational execution, and performance optimization of denial management and accounts receivable follow-up functions. This position is instrumental in driving revenue integrity, reducing avoidable denials, and ensuring timely and accurate reimbursement from payers.
Key Responsibilities:
Leadership & Strategy:
Develop and execute initiatives to reduce denial rates, improve claim resolution timelines, and maximize reimbursement.
Collaborate with clinical, coding, billing, and compliance teams to ensure accurate documentation and clean claim submission.
Lead the response to payer audits and appeals, ensuring timely, compliant, and effective resolution.
Serve as a key liaison with payer representatives to resolve systemic issues and negotiate favorable outcomes.
Establish and monitor performance metrics, including denial trends, days in AR, cash collections, and net revenue impact.
Process Improvement & Compliance
Ensure compliance with federal, state, and payer-specific billing and reimbursement regulations.
Drive continuous improvement through process redesign, automation, and adoption of advanced analytics tools.
Collaborate with compliance and audit teams to ensure adherence to HIPAA and other regulatory standards.
Team Leadership & Development:
Recruit, mentor, and develop high-performing teams, fostering a culture of accountability, collaboration, and excellence.
Supervise AR managers and staff; provide coaching, training, and performance evaluations.
Foster a culture of accountability, collaboration, and professional growth.
Qualifications:
Bachelor’s degree in healthcare administration, Business Administration, Finance, or a related field is required or job-related experience.
Equivalent combination of education and experience may be considered.
Skills & Competencies:
Knowledge of Medicare, Medicaid, and commercial payer policies and reimbursement structures.
Strong analytical and problem-solving skills
Excellent communication and leadership abilities
Proficiency in data analysis and reporting tools
Department: Revenue Cycle / Central Business Office
Reports To: Executive Director, CBO Revenue Cycle
Location: MedSrv Remote
Status: Full-Time / Exempt
Position Summary:
The Director of Denial Management & Follow-Up is a senior leadership role responsible for overseeing the strategic direction, operational execution, and performance optimization of denial management and accounts receivable follow-up functions. This position is instrumental in driving revenue integrity, reducing avoidable denials, and ensuring timely and accurate reimbursement from payers.
Key Responsibilities:
Leadership & Strategy:
Develop and execute initiatives to reduce denial rates, improve claim resolution timelines, and maximize reimbursement.
Collaborate with clinical, coding, billing, and compliance teams to ensure accurate documentation and clean claim submission.
Lead the response to payer audits and appeals, ensuring timely, compliant, and effective resolution.
Serve as a key liaison with payer representatives to resolve systemic issues and negotiate favorable outcomes.
Establish and monitor performance metrics, including denial trends, days in AR, cash collections, and net revenue impact.
Process Improvement & Compliance
Ensure compliance with federal, state, and payer-specific billing and reimbursement regulations.
Drive continuous improvement through process redesign, automation, and adoption of advanced analytics tools.
Collaborate with compliance and audit teams to ensure adherence to HIPAA and other regulatory standards.
Team Leadership & Development:
Recruit, mentor, and develop high-performing teams, fostering a culture of accountability, collaboration, and excellence.
Supervise AR managers and staff; provide coaching, training, and performance evaluations.
Foster a culture of accountability, collaboration, and professional growth.
Qualifications:
Bachelor’s degree in healthcare administration, Business Administration, Finance, or a related field is required or job-related experience.
Equivalent combination of education and experience may be considered.
Skills & Competencies:
Knowledge of Medicare, Medicaid, and commercial payer policies and reimbursement structures.
Strong analytical and problem-solving skills
Excellent communication and leadership abilities
Proficiency in data analysis and reporting tools