Denial & Appeals Manager

Howard University Hospital; Washington (District of Columbia); On-site; USD 86,000 - 96,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive medical, dental, and vis

Retirement savings plan

Paid time off and holiday pay

Tuition reimbursement and professional

Employee wellness programs

Supportive and mission-driven team

Job summary

Howard University Hospital, a nationally recognized academic medical center in Washington, DC, seeks an experienced Denial & Appeals Manager to lead denial prevention, appeals management, and revenue integrity initiatives.

The role coordinates denial and reimbursement activities, oversees utilization review, and partners with clinical, financial, and operational teams to optimize reimbursement and reduce revenue loss.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Minimum of five (5) years of healthcare, hospital revenue cycle, claims processing, reimbursement, collections, utilization review, or related management experience.
• Previous leadership or supervisory experience preferred.
• Strong knowledge of revenue cycle operations, denial management, appeals processes, and payer requirements.
• Experience working in a hospital or acute care healthcare environment.

Responsibilities

• Lead the denials and appeals process for inpatient and outpatient accounts, ensuring timely review, documentation, and follow-up.
• Coordinate resolution of escalated billing, reimbursement, and denial-related issues.
• Review clinical documentation and supporting records to facilitate successful appeal outcomes.
• Maintain accurate records related to authorization activity, utilization review, denial management, and appeal outcomes.
• Monitor insurance and authorization activity and maintain required tracking logs and reporting.
• Collaborate with physicians, clinical leadership, case management, patient access, coding, billing, and revenue cycle teams to address reimbursement challenges.
• Conduct research, audits, reviews, and assessments related to compliance, reimbursement integrity, and operational performance.
• Support internal audit, risk management, and regulatory compliance initiatives.
• Respond to inquiries regarding account status and reimbursement matters within established timelines.
• Train, mentor, and support staff involved in denial management and reimbursement integrity activities.
• Prepare and distribute reports related to denial trends, utilization review activities, and operational performance.
• Identify process improvement opportunities that enhance reimbursement outcomes and revenue cycle performance.

Skills

Denial management

Revenue cycle

Leadership

Payer requirements

Healthcare knowledge

Education

Bachelor's degree

Job description

Revenue Integrity | Howard University Hospital

Howard University Hospital is seeking an experienced Denial & Appeals Manager to lead denial prevention, appeals management, utilization review oversight, and revenue integrity initiatives. This position is responsible for coordinating denial and reimbursement activities, managing utilization review processes, ensuring timely appeals submissions, and partnering with clinical, financial, and operational teams to optimize reimbursement and reduce revenue loss. The manager serves as a key resource for denial mitigation, compliance, and revenue cycle improvement efforts.

Essential Responsibilities

• Lead the denials and appeals process for inpatient and outpatient accounts, ensuring timely review, documentation, and follow-up.
• Coordinate resolution of escalated billing, reimbursement, and denial‑related issues.
• Review clinical documentation and supporting records to facilitate successful appeal outcomes.
• Maintain accurate records related to authorization activity, utilization review, denial management, and appeal outcomes.
• Monitor insurance and authorization activity and maintain required tracking logs and reporting.
• Collaborate with physicians, clinical leadership, case management, patient access, coding, billing, and revenue cycle teams to address reimbursement challenges.
• Conduct research, audits, reviews, and assessments related to compliance, reimbursement integrity, and operational performance.
• Support internal audit, risk management, and regulatory compliance initiatives.
• Respond to inquiries regarding account status and reimbursement matters within established timelines.
• Train, mentor, and support staff involved in denial management and reimbursement integrity activities.
• Prepare and distribute reports related to denial trends, utilization review activities, and operational performance.
• Identify process improvement opportunities that enhance reimbursement outcomes and revenue cycle performance.

Required Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Minimum of five (5) years of healthcare, hospital revenue cycle, claims processing, reimbursement, collections, utilization review, or related management experience.
• Previous leadership or supervisory experience preferred.
• Strong knowledge of revenue cycle operations, denial management, appeals processes, and payer requirements.
• Experience working in a hospital or acute care healthcare environment.

Why Join Howard University Hospital?

About Howard University Hospital

With over 150 years of caring for our community in Washington, DC, Howard University Hospital is a nationally recognized academic medical center and designated Level I Trauma Center, providing the highest level of emergency and trauma care. As the nation’s only teaching hospital located on the campus of a Historically Black University, we are committed to clinical excellence, health equity, and training the next generation of healthcare leaders.

Our Emergency Department serves a diverse patient population and provides advanced trauma services, rapid stabilization, and complex emergency care in a dynamic, mission-driven environment.

What We Offer

• Competitive compensation
• Comprehensive medical, dental, and vision coverage
• Retirement savings plan
• Paid time off and holiday pay
• Tuition reimbursement and professional development support
• Employee wellness programs
• Supportive and mission-driven team environment

Pay + Schedule

• Pay Range: $85.5K - 96K
• FLSA Status: Exempt
• Schedule: (Monday–Friday); 8:00am - 4:30pm

Compliance Statements

Howard University Hospital promotes a Just Culture environment focused on accountability, learning, and patient safety. This culture supports the identification of human error, at-risk behavior, and reckless behavior, with the goal of maintaining safe systems and well-managed behavioral choices.

Howard University Hospital is an Equal Opportunity Employer and does not discriminate based on race, color, religion, sex, national origin, disability, veteran status, or any other protected characteristic under applicable law.

All employment offers are contingent upon successful completion of pre-employment screening, background investigation, and verification of credentials.