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Director - Denials Management

Company: Community Health System
Location: Sarasota
Posted on: May 3, 2021

Job Description:

Essential Duties and Responsibilities

(List in order of importance or percentage of time spent on the particular responsibility - High to Low

1.

Oversees centralized denial and appeal processes, ensuring standardization and compliance with established CHS policies and procedures, regulations of applicable regulatory agencies, and governmental payors

2.

Analyzes data for patterns and trends. Collaborates and educates facilities, SSC, Managed Care, and Corporate regarding aberrant issues. Offers recommendations for improvement

3.

Provides operational direction to Case Management, Coding, and assigned sites and business function. Coordinates site related issues with SSC administrative leadership

4.

Collaborates with all segments of leadership responsible for process design and development, process monitoring, and policy and procedure development. Manages all aspects of change management as it relates to operational processes, driving process metrics, staffing and employee relations, etc.

5.

Hires, trains, and develops assigned Managers, Supervisors, Analysts and others.

6.

Implements policy and procedure to create efficiencies and improve operations within the SSC environment to improve revenue cycle functions

7.

Ability to perform all other duties as assigned or requested

Keywords: Community Health System, Sarasota , Director - Denials Management, Other , Sarasota, Florida

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