Authorization Denials Manager

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November 19

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Shriners Children's

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Healthcare Insurance • Non-profit • Science

Shriners Children's is a non-profit organization that has been providing specialized pediatric care for over 100 years. With a commitment to excellence, their compassionate team of doctors and nurses focuses on delivering personalized care across various specialties, including burn care, orthopedics, and pediatric rehabilitation. They also engage in innovative research aimed at improving medical treatments and the overall quality of life for children.

10,000+ employees

Founded 1922

⚕️ Healthcare Insurance

🤝 Non-profit

🔬 Science

📋 Description

• Manage the denials and appeals process for all authorization denials, including reviewing denial reasons, gathering necessary documentation, and preparing appeals • Analyze authorization denial trends and identify opportunities for process improvement to prevent future denials • Collaborate with providers, including physicians, nurses, and other clinical staff, to gather supporting documentation for appeals • Communicate with insurance companies and third-party payers to ensure claims resolution and timely payment • Monitor the status of appeals and provide regular updates to stakeholders on progress and outcomes • Serve as a subject matter expert on insurance regulations, coverage policies, and reimbursement guidelines • Develop and implement training programs for staff on denials management best practices and appeal strategies • Maintain accurate records of denials, appeals, and outcomes for reporting and auditing purposes

🎯 Requirements

• 5-7 years revenue cycle experience • 3-5 years supervisor/manager experience • High School Diploma/GED • Bachelor's Degree (Preferred)

🏖️ Benefits

• All employees are eligible for medical coverage on their first day! • 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. • Eligible for paid time off, life insurance, short and long-term disability, and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. • Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more!