Manager, Payer Denials and Recovery

🔥 14 hours ago

🍑 Georgia – Remote

🍑 Georgia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Piedmont

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1905

🏥 Healthcare

Healthcare

Piedmont is a large regional healthcare system based in Georgia that operates hospitals, urgent care centers, QuickCare locations, and an extensive network of physician practices and clinical locations. The organization emphasizes clinical integration, workforce development (graduate medical education, nursing residency), and community-focused care, and it highlights a sizable workforce and patient reach (tens of thousands of team members, millions of patients and clinic visits, and thousands of provider and practice locations across Georgia). Piedmont’s career and patient-facing materials show a broad range of clinical and non-clinical services, system support functions, and a commitment to diversity, employee growth, and local community access to care.

📋 Description

• Provide leadership and oversight for Payer Denials and Recovery operations across Piedmont Healthcare • Manage day-to-day denial management, appeals, payer escalations, recoupment defense, underpayment recovery, interest payment recovery, reimbursement reconciliations, contract compliance reviews, denial analytics, self-funded TPA payment escalations, revenue recovery projects, and payer accountability initiatives • Protect earned revenue and recover underpayments • Defend inappropriate payer recoupments and reduce denial losses • Ensure payer compliance with contractual and regulatory obligations • Identify opportunities to improve reimbursement performance • Collaborate with Revenue Cycle Operations, Managed Care, Revenue Integrity, Finance, Informatics, Compliance, Legal, and payer organizations • Resolve complex reimbursement issues and support enterprise revenue recovery strategies • Oversee assigned functional areas including denials, appeals, payer escalations, recovery, compliance reviews, analytics, reconciliations, and regulatory recovery activities

🎯 Requirements

• Bachelor's Degree in Business Administration, Healthcare Administration, Finance, Accounting, Health Information Management or related field required, or six (6) years of additional Revenue Cycle experience in lieu of degree • 5 years of Revenue Cycle experience in denials management, appeals operations, payer recovery, underpayment recovery, contract compliance, revenue integrity, billing/follow-up, managed care reimbursement, third-party follow-up, or payment variance analysis required • If no degree, a total of eleven (11) years of experience required • 3 years of leadership or supervisory/management experience required • 8 or more years of Revenue Cycle experience preferred • 5 or more years of management experience preferred • Previous Epic Revenue Cycle experience preferred • Experience managing two or more specified payer denials, appeals, recovery, compliance, analytics, or dispute-resolution functions preferred • HFMA Certification, CRCR, RHIA, RHIT, CPC, Lean Six Sigma, or other healthcare financial certification preferred

🏖️ Benefits

• Remote work arrangement • Talent Community access for updates on upcoming opportunities

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