Director, Centralized Audits & Appeals

University of Iowa; Iowa City (IA); Hybrid; USD 110,000 - 160,000; Full time

Job summary

The University of Iowa seeks a Manager, Audits and Appeals to lead the centralized audits and appeals program. You will direct a multidisciplinary team handling payer audits, denials management, and audit responses, while partnering with Clinical Documentation Integrity and Revenue Cycle to strengthen revenue integrity.

Role requires advanced reimbursement knowledge, regulatory interpretation, and the ability to present complex analyses to leadership. Hybrid work within Iowa is available.

Qualifications

• Bachelor’s degree or equivalent in business, finance, or clinical field.
• Experience with Epic Patient Accounting System.
• 5 years in professional and facility revenue cycle operations.
• 2 years of supervisory experience.
• 2 years of experience with clinical/administrative denials and appeals.
• Working knowledge of physician and hospital reimbursement methods.
• Advanced experience with Microsoft Excel.
• Nursing or clinical background preferred.

Responsibilities

• Lead audit and appeal operations across centralized program including external and internal audits.
• Establish program metrics, dashboards, and reporting cadence with Revenue Integrity leadership.
• Develop and execute denial/appeal strategies to optimize reimbursement.
• Monitor and report KPIs: overturn rates, audit accuracy, financial impact, response time.
• Translate data into actionable insights for leadership and stakeholders.
• Collaborate with Revenue Cycle, Compliance, Coding, and clinical teams to resolve issues.
• Ensure compliance with federal regulations and payer requirements; refine workflows.
• Lead continuous improvement in denial prevention and revenue integrity.
• Manage and develop audit/appeal staff; performance management and training.
• Serve as SME on audit/appeal processes and regulatory changes.
• Be primary contact for audit tracking software.

Skills

Excellent written & verbal comms

Project management

Microsoft Office proficiency

CPT-4 & ICD-10 knowledge

Analytical storytelling to leadership

Regulatory interpretation

Education

Bachelor’s degree in business, finance, or clinical field

Master’s degree preferred

Tools

Epic Patient Accounting System

Job description

The University of Iowa seeks a Manager, Audits and Appeals to lead the centralized audits and appeals program. You will direct a multidisciplinary team handling payer audits, denials management, and audit responses, while partnering with Clinical Documentation Integrity and Revenue Cycle to strengthen revenue integrity.

Role requires advanced reimbursement knowledge, regulatory interpretation, and the ability to present complex analyses to leadership. Hybrid work within Iowa is available.