MANAGER- DENIALS PREVENTION - CENTRAL BILLING OFFICESalary Range: $39.62 - $63.41 Hourly
Schedule/Hours: DAY ONLY, 8 hours
Weekend Requirement: Generally No Weekends
FTE: FULL TIME, 1.000000 FTE
Off Premise On-Call: No
Job SummaryThe Manager - Denials Prevention responsible for driving enterprise-wide strategies to reduce payer denials and optimize reimbursement. This role focuses on proactive denial prevention across all points of the revenue cycle-from patient access to billing-by collaborating with clinical, operational, and financial stakeholders across the health system. The manager will lead data-driven initiatives to improve clean claim rates, reduce rework, and enhance financial performance. This position works to appropriately integrate and facilitate best practices, achieve efficiencies, and align with Aspirus' strategic plan.
Minimum Knowledge/Qualifications- Bachelor's degree or relevant years of experience equivalent in a work-related field/discipline from an accredited college or university required
- Minimum of 5 years' progressive leadership experience working in healthcare environment, especially in revenue cycle, or denials management required
- Knowledge of health system insurance billing practices highly desired
- Previous managerial experience highly desired
- Hospital and professional billing processes and reimbursement
- Medicare and Medicaid denials and appeals
- Third-party contracts
- Insurance protocols, delay tactics, systems, and workflows
- Federal and state regulations related to denials and appeals
- Possesses a high level of critical thinking and analytical skills
- Ability to work independently
- Ability to facilitate change effectively with cross-functional teams
- Ability to motivate, influence, and direct the work of others, often without authority
- Ability to resolve conflicts and negotiate with others to achieve positive results
- Ability to act as a thought leader for performance improvement and denials prevention
- Ability to communicate effectively at all organizational levels, both orally and in writing
- Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
- Possess efficient time-management skills and proven ability to multi-task under tight deadlines
- Exceptional writing and communication skills, including the ability to communicate technical concepts to a non-technical audience
- Strong comfort level with computer systems
- Ability to use independent, sound judgment with effective decision-making skills
Employee Benefits- Full benefits packages available for part- and full-time status.
- PTO accrual from day one!
- Generous retirement plan with match available.
- Wellness program for employees and their families.
Aspirus St. Luke's in Duluth is a cornerstone of health care in northeastern Minnesota, offering a wide range of medical specialties and advanced care services. With a history dating back to 1881, this downtown Duluth hospital has grown into a comprehensive medical center with a strong commitment to patient-centered care. The facility features a 267-bed hospital, state-of-the-art surgical and imaging technology, and a nationally recognized heart and vascular center. As part of the broader Aspirus system, St. Luke's is also known for its excellence in orthopedics, cancer care, and women's and children's health. In addition to the main hospital campus, the Duluth area includes multiple primary and specialty care clinics that serve the Twin Ports and surrounding communities. Duluth, MN
