Remote Denials Operations Leader

Healthrise; Southfield (MI); Hybrid; USD 95,000 - 130,000; Full time

Job summary

Healthrise in Southfield, MI seeks a Manager of Denials Operations to lead a team of denial specialists, oversee technical and coding denials across payer types, and align with Revenue Cycle goals.

This hands-on management role focuses on queue management, deadline adherence, root-cause analysis, staff development, and collaboration with cross-functional partners to improve upstream processes and reduce denials.

Qualifications

• Bachelor's degree in HIM, Healthcare Administration, Business, or related field.
• Minimum 5 years in healthcare revenue cycle with denials focus; 2+ years in leadership.
• Experience managing denial queues across Medicare/Medicaid/MA/commercial.
• Knowledge of ICD-10-CM/PCS, CPT, HCPCS and denial rationale.
• Familiarity with Medicare/Medicaid billing regs, timely filing rules.
• Proficiency with Epic, Cerner/Oracle Health, Meditech or similar EHR and denial tools.
• Completion of regulatory/mandatory certifications as required.
• Willingness to travel.

Responsibilities

• Manage daily denial work queues and ensure timely resolutions across payer types.
• Review and approve appeals for high‑dollar or complex denials.
• Collaborate with departments to trace root causes and drive upstream fixes.
• Develop staff through coaching, performance reviews, and onboarding.
• Monitor and report team performance metrics to leadership.
• Perform other duties as assigned.

Education

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

Tools

Epic

Cerner/Oracle Health

Meditech

Job description

Healthrise in Southfield, MI seeks a Manager of Denials Operations to lead a team of denial specialists, oversee technical and coding denials across payer types, and align with Revenue Cycle goals.

This hands-on management role focuses on queue management, deadline adherence, root-cause analysis, staff development, and collaboration with cross-functional partners to improve upstream processes and reduce denials.