Billing Denials, Manager - Emory Healthcare/Emory University

Overview



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Description



The Manager of Hospital Billing Denials is responsible for overseeing the day-to-day operations related to billing denials within the hospital system and/or related to professional services.



Reporting to the Director of Enterprise Denial Management, this role ensures efficient denial management processes, working collaboratively with billing teams and other departments to minimize claim denials and improve revenue recovery.



The position focuses on monitoring trends, identifying root causes of denials, and implementing corrective actions to optimize financial performance.



Denial Management & Resolution:

+ Oversee and monitor trend analysis, take operational ownership of denial reviews, and document progress with data on denial reduction.

Trend & Root Cause Analysis:

+ Analyze denial patterns to identify root causes, collaborating with cross-functional teams to implement strategies that prevent future denials.

Regulatory Compliance:

+ Ensure all denial management activities comply with federal, state, and payer-specific regulations.

Cross-functional Collaboration:

+ Work closely with departments such as Billing, Coding, and Case Management to streamline processes and improve communication.

Escalation & Problem Resolution:

+ Serve as the key escalation point for complex denial issues, collaborating with internal and external stakeholders to resolve disputes efficiently.

Reporting and Analysis:

+ Prepare, generate, and present reports on denial trends, recovery efforts, and financial impact to senior leadership, offering actionable insights and recommendations.

Stakeholder Communication:

Prepare and deliver reports and presentations on denial trends, financial impact, and process improvements to senior leadership and cross-functional teams.

MINIMUM QUALIFICATIONS:



Education:

+ Bachelors degree in Healthcare or Business Administration, or a related field is preferred. + However, 5 years of experience in healthcare billing or revenue cycle management may be substituted for the educational requirement.

Experience:

+ Minimum of 3 years of experience in healthcare billing or revenue cycle operations. + Strong analytical, problem-solving, and communication skills. Proficiency in healthcare billing systems. Licensure / Certification: + Epic Revenue Cycle Certifications and/or Certified Revenue Cycle Executive (CRCE) or similar certification is preferred. This position is 100% remote, offering flexibility in work location. The role requires occasional travel for training and meetings.

Additional Details



Supporting a diverse, equitable and inclusive culture.

Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. _Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training._

ACCOMODATIONS:

EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”

PHYSICAL REQUIREMENTS:

(Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS:

Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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Division

_Emory Healthcare Inc._

Campus Location

_Atlanta, GA, 30345_

Campus Location

_US-GA-Atlanta_

Department

_EHI Revenue Management_

Job Type

_Regular Full-Time_

Job Number

_138427_

Job Category

_Revenue Cycle & Managed Care_

Schedule

_8a-5p_

Standard Hours

_40 Hours_

Hourly Minimum

_USD $43.79/Hr._

Hourly Midpoint

_USD $59.11/Hr._ Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.