Denials Director

R1 RCM

5d • $108,742 - $144,587

About The Position

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Denials Director, you will act as a strategic leader dedicated to optimizing the organization's denial management processes. This role focuses on driving initiatives to reduce denials, improve revenue recovery, and enhance overall financial performance. The Denials Director will collaborate with senior leadership and cross-functional teams to align departmental strategies with organizational goals, fostering a culture of continuous improvement and excellence in denials management. Here’s what you will experience working as a Denials Director: Strategic Leadership: Develop and implement the overall vision and strategy for denial management within the revenue cycle management department, ensuring alignment with the organization's financial goals and objectives. Financial Alignment: Ensure alignment with division cash goals and drive strategic initiatives to optimize financial performance, particularly in reducing denial rates and improving revenue recovery. Cross-Departmental Coordination: Lead and coordinate efforts across all operational and support verticals to ensure seamless workflow optimization and integration in denials management. Data Analysis and Strategy: Analyze denial reports, identify trends and root causes, and develop strategic initiatives to mitigate future denials and enhance revenue cycle efficiency. Policy and Compliance Management: Develop, implement, and maintain comprehensive policies and procedures for denials and appeals management, ensuring compliance with industry standards and payer regulations. Stakeholder Collaboration: Collaborate with senior leaders and other departments, such as coding, clinical documentation, case management and patient access, to enhance the quality and accuracy of billing and documentation processes related to denials. Reporting and Metrics: Oversee the preparation and presentation of comprehensive monthly reports on key denial metrics, such as denial rate, appeal success rate, aging accounts receivable, and revenue recovery, to executive leadership. Process Improvement: Identify and lead initiatives for process improvement, cost reduction, and revenue enhancement, driving innovation to optimize denials management within the revenue cycle.

Requirements

• Bachelor's Degree (Required)
• Proven experience in a senior management role within revenue cycle management, with a track record of strategic leadership and successful implementation of denial management and revenue optimization initiatives.
• Strong analytical, leadership, and communication skills, with the ability to influence and drive change across a complex organization.

Nice To Haves

• Advanced degree in Business Administration, Healthcare Management, or related field preferred.

Responsibilities

• Develop and implement the overall vision and strategy for denial management within the revenue cycle management department, ensuring alignment with the organization's financial goals and objectives.
• Ensure alignment with division cash goals and drive strategic initiatives to optimize financial performance, particularly in reducing denial rates and improving revenue recovery.
• Lead and coordinate efforts across all operational and support verticals to ensure seamless workflow optimization and integration in denials management.
• Analyze denial reports, identify trends and root causes, and develop strategic initiatives to mitigate future denials and enhance revenue cycle efficiency.
• Develop, implement, and maintain comprehensive policies and procedures for denials and appeals management, ensuring compliance with industry standards and payer regulations.
• Collaborate with senior leaders and other departments, such as coding, clinical documentation, case management and patient access, to enhance the quality and accuracy of billing and documentation processes related to denials.
• Oversee the preparation and presentation of comprehensive monthly reports on key denial metrics, such as denial rate, appeal success rate, aging accounts receivable, and revenue recovery, to executive leadership.
• Identify and lead initiatives for process improvement, cost reduction, and revenue enhancement, driving innovation to optimize denials management within the revenue cycle.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees