Shared Services Center - Nashville
Manager, Denial Unit (REMOTE)
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Full Time
Job Summary
The Manager, Denial Unit is responsible for managing appeals and denials staff in processing accounts and working with designated payors to ensure proper reimbursement, maximize cash flow, and reduce aging accounts receivable.
As a Manager, Denial Unit at Community Health Systems (CHS) - PCCM, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k.
Essential Functions
The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.
Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
The Manager, Denial Unit is responsible for managing appeals and denials staff in processing accounts and working with designated payors to ensure proper reimbursement, maximize cash flow, and reduce aging accounts receivable.
As a Manager, Denial Unit at Community Health Systems (CHS) - PCCM, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k.
Essential Functions
- Ensures compliance with state and federal laws and regulations.
- Maintains a thorough understanding of health insurance and government programs, where necessary.
- Maintains understanding of contracts and works with corporate on contractual issues as needed.
- Facilitates the identification of issues and solutions by team members related to delays in achieving payment resolution and, in identifying trends of denials seen to prevent ongoing losses.
- Monitors collection of appealed accounts to maintain timely collections of cash.
- Works with all other department managers to identify department training needs for system education, industry updates and changes in collection processes and protocols.
- Works with Director and staff to ensure that employee productivity and quality meets standards.
- Manages workflow, employee productivity, and collection efforts for assigned team.
- Performs other duties as assigned.
- Complies with all policies and standards.
- H.S. Diploma or GED required
- Bachelor's Degree required
- Master's Degree preferred
- 3-6 years Previous experience or training in healthcare business office policies, practices and procedures required
- 3-6 years Related experience in denials and appeals required
- 2-4 years Supervisory experience required
- To perform this job successfully, an individual should be proficient in and/or able to easily learn multiple software programs, including Word, Excel, and Google suite.
The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.
Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.