Manager Payer Audit and Denials Management

UCHealth; Denver (CO); On-site; USD 54,000 - 87,000; Full time

Benefits offered by this job

Performance bonus

Annual merit pay increase

Market adjustments

Tuition reimbursement

Tuition assistance program

Job summary

UCHealth in Denver, CO seeks a Denials Management and Payer Audit leader to oversee daily operations of the denials and payer audit functions, aligning with organizational goals. The role manages external payer audits, drives process improvement, develops executive dashboards, and collaborates across departments to preserve revenue while leading a cross-functional team.

A Bachelor's degree is preferred and at least 3 years of related experience is required.

Qualifications

• High school diploma or GED required; Bachelor's degree preferred.
• At least 3 years of related experience.

Responsibilities

• Oversees external payer audit and denials prevention functions to drive process improvement and maximize revenue preservation.
• Manages staff relations, performance management, and cross-functional consolidation of departments.
• Monitors budgets, regulatory compliance, contracts, and vendor relations; justifies needs for systems and supplies.
• Requires critical thinking, decisive judgment, and ability to work with minimal supervision in a fast-paced environment.

Skills

Payer audit

Denials management

Education

High school diploma or GED

Bachelor's degree preferred

Job description

Location

UCHealth UCHlth Admin Lowry, US:CO:Denver

Department

UCHlth Denials Mgt Payer Audit

Work Schedule

Full Time, 80.00 hours per pay period (2 weeks)

Shift

Days

Pay

$39.32 - $62.90 / hour. Pay is dependent on applicant's relevant experience

Summary

Manages the daily operations of the assigned compliance function(s) to ensure alignment with departmental and organizational objectives.

Responsibilities

• Oversees and manages external payer audit and denials prevention functions to drive process improvement and maximize revenue preservation. Assists with planning, developing, and implementing programs, projects, strategies, processes and technology to continuously improve and manage the Payer Audit Management and Denials Management departments supporting the financial goals of the organization. Develops and maintains executive dashboards and summaries. Collaborates with leadership and stakeholders across the organization to improve processes. Acts as a liaison between internal colleagues and payers.
• Manages staff relations including performance management, staff satisfaction, conflict management and compliance with organizational and departmental policies and guidelines. Monitors staff quality and productivity through key performance indicators. Leads a complex, cross-functional consolidation of two departments with a focus on innovation and expansion of subject matter expertise in an efficient manner, executing on both short and long term strategies. Identifies issues through root-cause analysis. Engages appropriate stakeholders to implement processes to reduce audits, denials, and lost revenue. Supports special projects and business analysis as requested. Acts as a subject matter expert in denials and payer auditing.
• Monitors departmental budgets, regulatory compliance, departmental contracts, and vendor relations. Determines and justifies needs for system/equipment/supply purchases, monitors usage, and oversees proper working order and/or stock supplies.
• Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements

• High school diploma or GED. Bachelor's degree preferred.
• 3 years of related experience.

Employees are our number one asset.

UCHealth promotes a culture that invests in professional success and personal well-being through a comprehensive total rewards program.

Recognition

• Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure. The bonus accumulates annually each October and is paid out in October during the third year of employment.
• Performance-based pay increase: The Annual Merit Pay Increase recognizes work performance that meets or consistently exceeds performance standards documented through UCHealth's established evaluation process and accounts for increased experience, skills and cost of living.
• Market reviews: All UCHealth positions are reviewed annually to ensure UCHealth base pay aligns with market standards. Base pay rates are adjusted as needed to stay market competitive.

Health and well-being

• Medical, dental and vision coverage.
• Access to 24/7 mental health and well-being support for employees and dependents.
• Discounted gym memberships and fitness resources.
• Free Care.com membership.
• Voluntary benefits such as accident insurance, critical illness insurance, group legal plan, identity theft protection, pet insurance, auto and home insurance, and employee discount programs.
• Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence.
• Employer-provided basic life and accidental death and dismemberment coverage with buy-up coverage options.
• Employer-provided short-term disability and long-term disability with a buy-up coverage option.

Retirement and savings

• 403(b) plan with employer matching contribution.
• Additional 457(b) plan may be available.
• Flexible spending accounts for health care and dependent day care; health savings account available when enrolled in high-deductible (HD) medical plan.

Education and career growth

• UCHealth provides access to academic degrees and certificate programs to promote professional and personal growth.
  • Up to 100% of tuition, books and fees paid for by UCHealth for specific educational degrees.
  • Other programs may qualify for up to $10,000/year pre-paid by UCHealth or up to $5,250/year in the form of tuition reimbursement.
• Access to LinkedIn Learning, which offers thousands of virtual courses and seminars, and internal professional development opportunities.
• Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness.
• Eligibility for some programs is based on an employee's scheduled work hours.

We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.

UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when the do not impose an undue hardship on the organization.