PFS Denials & Appeals Supervisor

Bayhealth; Dover (DE); On-site; USD 57,554 - 86,320; Full time

Benefits offered by this job

Paid Time Off

401(k) Matching

Health Insurance

Educational Reimbursement

Health/Dental/Vision Insurance

Job summary

Bayhealth in Dover, DE seeks a Patient Financial Services (PFS) Supervisor to lead denial and appeals operations. The role ensures regulatory compliance and improves reimbursement through staffed workflows and data analysis. Strong leadership within hospital A/R is essential.

The ideal candidate manages daily operations, coordinates staff, and collaborates with clinical and legal teams to optimize revenue cycle processes at Bayhealth.

Qualifications

• Minimum five years of hospital A/R or patient accounting experience at Bayhealth.
• Preferred: Lead or Supervisory experience.

Responsibilities

• Monitor daily workflow, manage inventory levels, and ensure cases are resolved within regulatory and payer timeframes. Review A/R analysis and high-dollar accounts (> $25,000); document reviews.
• Assign and prioritize work, coordinate daily activities; recruit, train, coach, and supervise appeal specialists; set productivity and quality goals.
• Analyze denial trends, identify root causes, and develop corrective actions; ensure denial reporting tool is current for real-time and month-end analysis.
• Review appeals for accuracy; maintain audit readiness and update policies and manuals.
• Complete monthly rounding on direct reports and maintain rounding logs to facilitate communication.
• Serve as SME; partner with internal departments and external entities; monitor external contractor performance.
• Review system change requests for payer impact; ensure evidence supports changes and validation.
• Other duties as assigned.

Skills

Supervisory experience

Leadership

Education

High School Diploma or GED

Job description

Bayhealth in Dover, DE seeks a Patient Financial Services (PFS) Supervisor to lead denial and appeals operations. The role ensures regulatory compliance and improves reimbursement through staffed workflows and data analysis. Strong leadership within hospital A/R is essential.

The ideal candidate manages daily operations, coordinates staff, and collaborates with clinical and legal teams to optimize revenue cycle processes at Bayhealth.