System Director Claim Denials, Revenue Cycle Accounts Receivable

SSM Health; Missouri; Remote; USD 100,000 - 130,000; Full time

Job summary

A leading healthcare organization is looking for a Director of Denial Operations to oversee denial activities within the revenue cycle. This remote position focuses on improving processes, educating departments, and leading teams to enhance efficiency in denial management. The role offers competitive benefits and is integral to the organization's stated mission of providing exceptional healthcare.

Benefits

Paid parental leave

Flexible payment options

Upfront tuition coverage

Qualifications

• 7+ years of experience in revenue cycle and denial management.
• 5+ years in leadership roles required.

Responsibilities

• Lead managers and teams to identify denial process issues.
• Manage denials across multiple states and payer environments.
• Oversee communication and report financial impacts of denials.

Skills

Leadership

Denial Management

Process Improvement

Root Cause Analysis

Education

Bachelor's degree in business, healthcare, or related field

Job description

It's more than a career, it's a calling.

MO-REMOTE

Worker Type: Regular

Job Highlights:

Named 150 Top Places to Work in Healthcare 2024 - Becker's Healthcare
Named One of the Diversity Leaders 2024 – Modern Healthcare
Named One of America's Greatest Workplaces for Diversity 2024 - Newsweek
Named One of America's Greatest Workplaces for Women 2024 – Newsweek
Named One of America’s Greatest Workplaces for Job Starters 2024 – Newsweek

SSM Health is a Catholic, not-for-profit health system serving communities across the Midwest with hospitals, clinics, home care, and more. With 40,000 team members, we are committed to providing exceptional healthcare and revealing God’s healing presence.

This position is remote work eligible within MO, WI, IL, OK, AL, FL, GA, IA, IN, KS, KY, LA, MI, NC, SC, TN, TX, UT, VA, WV. To request more info or nominate a colleague, contact:

Angela Jones
Executive Talent Partner
[e-mail]

Job Summary:

Directs, coordinates, and oversees denial activities within the revenue cycle, focusing on post-billed denials including clinical denials. Engages with leadership to identify root causes of denied claims and implements process improvements.

Responsibilities and Requirements:

Primary Responsibilities

• Lead managers and teams in identifying denial process issues, fostering motivation and high performance.
• Manage denials activities across multiple states and payer environments, directing teams to resolve trends efficiently.
• Provide strong leadership, lead projects for process improvements, and ensure cost-effective quality services.
• Lead root cause analysis and process redesigns to improve denial management.
• Oversee communication, follow-up, and reporting related to denials and appeals.
• Coordinate with medical staff and regional colleagues on denial processes.
• Educate departments on denial prevention and appeal strategies.
• Collaborate with HIM and Case Management on concurrent denials and revenue opportunities.
• Report financial impacts of denials to senior leadership.
• Perform other duties as assigned.

Education: Bachelor's degree in business, healthcare, or related field, or equivalent experience.

Experience: 7+ years, including 5+ years in leadership roles.

Department: Revenue Cycle Denial Operations

Work Shift: Day Shift, 40 hours/week

Benefits: Comprehensive package including paid parental leave, flexible payment options, upfront tuition coverage, and more. Explore All Benefits

SSM Health is an equal opportunity employer. Click here to learn more about our diversity and inclusion policies.