"Commercial/Managed Care and Denial Manager - HB Patient Financial Services - FT Days"

The Commercial/Managed Care Collections/Denials Manager reports to the Assistant Director-Patient Financial Services and is responsible for managing hospital accounts receivables (A/R) and the collections, denial, and workflow activities for Commercial/Managed Care payers - Commercial, Managed Care, Workers Compensation, TriWest/VA and all other third-party payers. The incumbent manages daily operations certifying timely accurate account evaluation, escalation, and resolution ensuring compliance with procedures, standards, and policies as well as regulatory requirements. This role is responsible for training, managing work performance, A/R analysis, resolution of operational and personnel issues, evaluations, hiring, and corrective actions as needed. Presents as a key liaison between PFS and various departments leaders within the organization to identify and resolve issues relating to charges, coding, appropriate modifiers, and claim adjudication to yield first pass clean billing and enhanced revenue recoveries. Also responsible for performing routine analysis of various key performance indicators, dashboards, and reports to optimize performance and maintain positive A/R disposition.