Denials Manager

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.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
PS: It's All About You!
American Family Care has pioneered the concept of convenient, patient-centric healthcare. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. Ranked by Inc. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient.
If you are looking for an opportunity where you can make a difference in the lives of others, join us on our mission. We invite you to grow with us and experience for yourself the satisfying and fulfilling work that the healthcare industry provides.
Please note that a position may be for a company-owned or franchise location. Each franchise-owned and operated location recruits, hires, trains, and manages their own employees, sets their own employment policies and procedures, and provides compensation and benefits determined by that franchise owner. Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more.
We are an Equal Opportunity Employer