Healthcare Collections Manager-Hospital Denials

ERISA Recovery; Plano (TX); In loco; USD 110.000 - 140.000; Tempo pieno

Vantaggi offerti da questo lavoro

401(k)

Health insurance

Vision insurance

Paid vacation

Lunch program

Disability insurance

Life Insurance

Descrizione del lavoro

ERISA Recovery, Inc. is seeking an experienced Collections Manager to lead a team of Analysts focused on hospital claim denials and appeals within our ERISA-focused revenue cycle practice.

You will develop performance strategies, coach staff, optimize workflows, and ensure compliant, timely claim recoveries through collaboration with insurance carriers and hospitals. This leadership role demands a data-driven approach and strong stakeholder communication.

Competenze

• Minimum 3 years in healthcare revenue cycle, denial management, or hospital billing.
• Minimum 5 years in leadership within healthcare collections or revenue cycle.
• Extensive knowledge of hospital denials, appeals, and reimbursement processes.
• Strong medical terminology and coding (CPT/HCPCS, ICD).
• Experience with EHRs, claims systems, and payer portals.
• Analytical mindset with data-driven improvement ability.
• Excellent communication and leadership skills.

Mansioni

• Lead and develop Analysts focused on hospital claim recovery and appeals.
• Set clear performance expectations using BI and operational data.
• Coach performance reviews and professional development activities.
• Foster accountability, collaboration, and continuous improvement.
• Monitor productivity, recovery metrics, and SOP effectiveness.
• Develop and refine departmental SOPs and workflows.
• Identify opportunities to maximize claim recoveries and efficiency.
• Ensure compliance with policies, regulations, and payer requirements.
• Analyze performance trends and provide strategic leadership reporting.
• Collaborate with carriers and hospitals to facilitate claim recovery.
• Provide subject-matter expertise on reimbursement methodologies.

Conoscenze

Healthcare revenue cycle

Leadership

Denials & appeals

CPT/HCPCS knowledge

ICD codes

Payer contracts

EHRs

Data analytics

Communication

Formazione

Bachelor's degree

Strumenti

EHRs

Claims management systems

Payer portals

Descrizione del lavoro

Do you have extensive hands-on experience with hospital claim denials, appeals, and revenue cycle management?

ERISA Recovery is a national leader in the federal ERISA appeals process, specializing in the recovery of complex, high-value, and aged healthcare claims. Our team partners with hospitals and healthcare organizations to recover revenue from claims that have been denied, underpaid, or previously considered uncollectible.

We are seeking an experienced Collections Manager to lead our team of Analysts and drive operational excellence within our claims recovery division. This leadership role is responsible for developing performance strategies, coaching team members, optimizing workflows, and ensuring successful recovery outcomes through effective management of hospital denial and appeals processes.

Position Summary:

The Collections Manager will oversee a team responsible for resolving complex hospital claim denials and securing reimbursement from insurance carriers. This role requires a strong background in healthcare revenue cycle management, denial resolution, appeals, and team leadership.

The ideal candidate is a results-driven leader who can leverage data and business intelligence to improve performance, establish accountability, and support organizational growth.

Key Responsibilities:

• Leadership & Team Development
• Lead, mentor, and develop a team of Analysts focused on hospital claim recovery and appeals.
• Establish clear performance expectations and measurable goals using business intelligence and operational data.
• Conduct regular coaching sessions, performance reviews, and professional development activities.
• Foster a culture of accountability, collaboration, and continuous improvement.
• Operational Management
• Monitor team productivity, recovery performance, and key operational metrics.
• Develop, implement, and refine departmental Standard Operating Procedures (SOPs).
• Identify process improvement opportunities to increase efficiency and maximize claim recoveries.
• Ensure compliance with company policies, industry regulations, and payer requirements.
• Strategic Reporting & Analytics
• Analyze performance trends and recovery metrics to drive operational decision-making.
• Provide regular reporting and strategic recommendations to executive leadership, including the CEO and CFO.
• Utilize data insights to improve workflow effectiveness and support company growth initiatives.
• Revenue Cycle & Denials Expertise
• Oversee complex hospital claim denial resolution and appeals processes.
• Collaborate with insurance carriers, hospitals, and internal stakeholders to facilitate successful claim recovery.
• Serve as a subject matter expert on reimbursement methodologies, payer policies, and denial management strategies.
• Support ongoing training initiatives to strengthen team expertise in revenue cycle operations.

Required Qualifications:

• Minimum of 3 years of healthcare revenue cycle, hospital billing, or denial management experience.
• Minimum of 5 years of leadership or management experience within a healthcare collections, revenue cycle, or reimbursement environment.
• Extensive knowledge of hospital claim denials, insurance appeals, and reimbursement processes.
• Strong understanding of:
• Medical terminology
• CPT/HCPCS coding
• ICD diagnosis codes
• Payer contracts and reimbursement methodologies
• Experience using Electronic Health Records (EHRs), claims management systems, and insurance payer portals.
• Advanced analytical and problem-solving skills with the ability to interpret performance data and implement actionable improvements.
• Strong communication, organizational, and leadership abilities.
• Experience managing teams focused on complex insurance appeals or ERISA-related claims.
• Proven success improving operational performance through metrics-driven management.
• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field preferred.
• 401(k), matching
• Health insurance
• Vision insurance
• Paid vacation
• Lunch program
• Disability insurance
• Life Insurance

Ability to Commute:

ERISA Recovery is an Equal Opportunity Employer