Manager Professional Billing & Denial Recovery

methodisthealthsystem

Dallas (TX)

Hybrid

USD 90,000 - 130,000

Full time

10 days ago

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Job summary

Methodist Health System in Dallas, TX, seeks a Manager to oversee AR specialists and a Team Lead within the Central Business Office. The role focuses on setting performance goals, reducing accounts receivable, and improving processes in collaboration with the Director.

Requirements include a bachelor's degree in healthcare administration or related field, 5+ years in physician billing or revenue cycle management, and 3+ years of leadership experience.

Qualifications

Education: Bachelor's degree in Healthcare Administration, Business, or related field required. Master's preferred.
Experience: 5+ years in physician billing, revenue cycle management, or payer relations; 3+ years of direct leadership experience.
Knowledge Base: In-depth understanding of CPT/HCPCS/ICD-10 coding, payer-specific requirements, and CMS guidelines for physician services.
Systems: Epic experience required; experience with denial management systems and reporting tools preferred.
Certifications: Certification through HFMA, AAHAM, or Epic (PB Resolute or Claim Edit) preferred for new hires; encouraged for incumbents.

Responsibilities

Leads all post-bill follow-up and denial resolution activities across all payers, ensuring timely resolution and maximum reimbursement for multi-specialty physician services.
Directs the appeals and reconsideration process, including root cause analysis, persuasive appeal writing, and submission accuracy.
Collaborates with Revenue Integrity and Coding teams to ensure accurate documentation, reduce revenue leakage, and ensure compliant charge capture.
Oversees Epic workqueue utilization, provides optimization feedback, and partners with IT to support performance improvement.
Manages a team of AR staff (including one Team Lead), focusing on team coaching, performance monitoring, productivity tracking, and staff development.
Conducts denial trend analysis and leads cross-functional discussions to resolve clinical, documentation, or billing workflow barriers.
Supports AR goals, denial recovery metrics, and process improvement initiatives in partnership with the Director of Physician Revenue Optimization.
Participates in enterprise revenue cycle meetings, peer manager forums, and professional development efforts.
Contributes to cultural engagement, team-building initiatives, and talent development in alignment with Methodist Health's leadership standards.

Skills

Leadership experience

Effective communication

Teamwork

Education

Bachelor's degree in Healthcare Administration, Business, or related field

Master's degree preferred

HFMA certification

AAHAM certification

Epic PB Resolute or Claim Edit certification preferred

Tools

Epic experience

Denial management systems

Reporting tools

Job description

Hours of Work

Days of Week

Mon-Fri

Job Description

Your Job: The Manager in this role is responsible for the oversight of AR Specialist and a Team Lead. Setting and achieving performance goals by fostering teamwork, effective communication and moving conflict to collaboration within the Central Business Office. Monitors and improves all efforts to reduce accounts receivables according to goals established by MHS Administration. Monitors quality of work and proactively reviews trends and variances that may delay reimbursement. Works with the Director to prioritize departmental initiatives to develop, implement, monitor, and communicate annual goals and objectives. Understanding and knowledge of budgets and performance standards for the area of responsibility in order to evaluate opportunities for cost saving and quality improvement. Interacts with Human Resource including hiring, training, coaching, counseling for employees in the area of their responsibility.

Your Job Requirements

Education: Bachelor's degree in Healthcare Administration, Business, or related field required. Master's preferred.
Experience: 5+ years in physician billing, revenue cycle management, or payer relations; 3+ years of direct leadership experience.
Knowledge Base: In-depth understanding of CPT/HCPCS/ICD-10 coding, payer-specific requirements, and CMS guidelines for physician services.
Systems: Epic experience required; experience with denial management systems and reporting tools preferred.
Certifications: Certification through HFMA, AAHAM, or Epic (PB Resolute or Claim Edit) preferred for new hires; encouraged for incumbents.

Your Job Responsibilities

Leads all post-bill follow-up and denial resolution activities across all payers, ensuring timely resolution and maximum reimbursement for multi-specialty physician services.
Directs the appeals and reconsideration process, including root cause analysis, persuasive appeal writing, and submission accuracy.
Collaborates with Revenue Integrity and Coding teams to ensure accurate documentation, reduce revenue leakage, and ensure compliant charge capture.
Oversees Epic workqueue utilization, provides optimization feedback, and partners with IT to support performance improvement.
Manages a team of AR staff (including one Team Lead), focusing on team coaching, performance monitoring, productivity tracking, and staff development.
Conducts denial trend analysis and leads cross-functional discussions to resolve clinical, documentation, or billing workflow barriers.
Supports AR goals, denial recovery metrics, and process improvement initiatives in partnership with the Director of Physician Revenue Optimization.
Participates in enterprise revenue cycle meetings, peer manager forums, and professional development efforts.
Contributes to cultural engagement, team-building initiatives, and talent development in alignment with Methodist Health's leadership standards.

Work Arrangement

Hybrid - Onsite 2 days per week or as required by leadership.

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we've earned: