The Supervisor of Denials Management and Efficiency is accountable for driving operational excellence within the Billing Office by improving workflows, reducing denials, and fostering collaboration across MVHS. This position leads a focused team dedicated to denial prevention and workflow optimization. Success in this role will be measured by reductions in denial-related write-offs, initial denial rate, and adoption of workflow changes across teams.

Core Job Responsibilities

Supervise the daily activities of assigned staff within the Billing Office.
Monitor denial trends, perform root cause analysis, and implement prevention strategies.
Partner with stakeholders within and outside of the Revenue Cycle (clinical departments, patient access, finance, payers, IT) to ensure denials and inefficiencies are mitigated.
Create and implement denial prevention initiatives to reduce recurring issues and protect net revenue.
Analyze and standardize billing and denial follow-up workflows to streamline processes, improve efficiency and accuracy, increase denial overturn rates, and reduce variation and errors.
Collaborate with IT, operations, and leadership to ensure Epic workflows and system builds align with operational goals by translating issues into requirements and driving projects to completion.
Provide mentorship, feedback, and development opportunities; guide specialists in complex workflows and projects; and mentor analysts to produce actionable, data-driven insights.
Escalate systemic denial issues to payer representatives, state or governing bodies, or legal counsel when egregious payer practices are identified.
Develop expertise in payer contracts and Epic billing workflows to minimize payment variances.
With the Manager and Human Resources guidance, provides input to or makes recommendations on employee hires, performance reviews, transfers, promotions, disciplinary actions, terminations and similar actions. Resolves grievances and other staff problems in a fair, timely and consistent manner also in conjunction with HR.
Perform other duties as required.

Education/Experience Requirements

REQUIRED:

High school diploma in a business related field, or equivalent work experience in a related field.
5 year of experience in hospital billing.
Knowledge of insurance appeals, payer rules, denial resolution processes.
Experienced in statistics, root cause analysis and project management.
Ability to build trust and influence across diverse teams and leadership levels.
Excellent written, verbal and interpersonal communication skills.

PREFERRED:

Associate or Bachelors in a business related field

Licensure/Certification Requirements

PREFERRED:

CRCR (Certified Revenue Cycle Representative)
RHIA
RHIT
or similar certification

Disclaimer

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.

Job Details

Req Id 96203
Department ACCTS RECEIVABLE & COLLECTION
Shift Days
Shift Hours Worked 8.50
FTE 1
Work Schedule HRLY NON-UNION-8 HR
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $24 - $37

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