Clinical Denials Manager

Job Summary

A company is looking for a Manager, Clinical Denials.

Key Responsibilities

• Oversees the denial and appeal processes, ensuring alignment with financial and compliance goals
• Maintains clinical appeal processes for outpatient and physician denials, ensuring proper documentation and timely adjustments
• Provides education and support to the Clinical Denial staff and monitors denial trends for process improvement

Required Qualifications

• High School Diploma or Equivalent
• Five years of experience in healthcare accounts receivables management, billing, and collections
• Three years of experience in healthcare denial management with knowledge of CPT codes
• Bachelor's degree in Finance, Business Administration, or related field is preferred
• Certified Healthcare Financial Professional (CHFP) is preferred