Enterprise Authorization Services Lead

WVU Medicine; United States; Remote; USD 85,000 - 110,000; Full time

Job summary

SYSTEM West Virginia University Health System is seeking a senior manager to coordinate and lead the authorization and denial management unit. You will oversee a team of authorization specialists, ensure timely pre-certifications, and work with revenue cycle to minimize denials.

The role requires strong knowledge of payer rules, EPIC, CPT/ICD coding, and regulatory compliance, with emphasis on leadership and process improvement in a hospital setting.

Qualifications

• High School Diploma or Equivalent is required.
• Five (5) years’ experience healthcare accounts receivables management, billing and collections.
• Two (2) years of supervisory experience.

Responsibilities

• Manage and lead a team including interviewing, hiring, training, directing work processes and performance management.
• Communicate effectively with hospital personnel and departmental leaders.
• Monitor revenue risks and develop/implement action plans to mitigate denials.
• Stay updated on regulatory billing requirements and compliance policies.
• Oversee denial management analytics and multi-departmental resolution efforts.

Education

High School Diploma or Equivalent

Bachelor’s degree in Finance, Business Administration or related field

Certified Healthcare Financial Professional (CHFP) with HFMA

Job description

SYSTEM West Virginia University Health System is seeking a senior manager to coordinate and lead the authorization and denial management unit. You will oversee a team of authorization specialists, ensure timely pre-certifications, and work with revenue cycle to minimize denials.

The role requires strong knowledge of payer rules, EPIC, CPT/ICD coding, and regulatory compliance, with emphasis on leadership and process improvement in a hospital setting.