Senior Vice President, Delivery – Denials Resolution, Payment Compliance

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🔥 16 hours ago

🏈 Alabama, Arizona, +18 more states – Remote

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⏰ Full Time

🟠 Senior

👔 Vice President

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Logo of Knowtion Health

Knowtion Health

501 - 1000 employees

Founded 2008

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2020-09

Consulting • Insurance • Logistics

Knowtion Health is a company that assists hospitals in handling denied and complex claims, recovering low balance accounts, and providing defense against payer audits. By leveraging advanced technology and a team of experts, Knowtion Health aims to maximize revenue and improve patient experiences. Their services include addressing clinical denials and managing various challenging payer classes, positioning them as a strong advocate for their clients in the healthcare sector.

📋 Description

• Own strategy, performance, and financial accountability for Clinical Denials, Underpayments, and Interest & Penalties • Lead denial review, audit, and appeal operations • Ensure quality, timeliness, compliance, and overturn performance meet expectations • Direct identification, validation, and recovery of payer underpayments • Manage contract modeling, recovery targets, aging management, and escalation processes • Lead Interest & Penalties recovery and ensure compliance with payer contracts, prompt-pay requirements, and healthcare regulations • Build, mentor, and manage a high-performing leadership team • Establish productivity, quality, and financial performance standards • Partner with executive, clinical, coding, compliance, and delivery leaders • Drive root-cause remediation, process and technology improvements, automation, and client delivery alignment • Report to the Chief Delivery Officer

🎯 Requirements

• Bachelor's degree in healthcare administration, business, finance, or a related field required • 10+ years of progressive experience in healthcare revenue cycle management • Direct experience in denials management, underpayments, and/or payer contract compliance • 5+ years of senior leadership experience managing multidisciplinary teams • Working knowledge of healthcare payer regulations, prompt-pay requirements, and applicable dispute resolution processes • Demonstrated track record of driving measurable financial recovery and operational performance improvement • Excellent leadership, communication, and cross-functional collaboration skills • Experience with payer appeals processes, contract modeling, and interest/penalty recovery strongly preferred • Relevant industry certifications such as CRCR, CHFP, CPC, or similar are a plus • Must present a valid government-issued photo ID during screening and/or interviews • Must have a dedicated, distraction-free workspace at home

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Life insurance • Short-term disability insurance • Long-term disability insurance • Paid holidays • 401(k) • Generous PTO policy • Remote work with a dedicated, distraction-free workspace at home

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