The Manager - Enterprise Professional Coding Denials is responsible for leading UVA Health's professional coding denial prevention and resolution initiatives. This role oversees the full lifecycle of professional claim denials, ensuring appropriate coding, accurate reimbursement, and compliance with payer guidelines. The Denials Manager collaborates across the health system-including providers, coders, educators, clinical departments, and revenue cycle teams-to reduce avoidable denials, strengthen appeal strategies, and support organizational revenue integrity efforts.
This position serves as UVA Health's subject matter expert for professional coding-related denials as well as payer policy interpretation and compliance and plays a key role in performance improvement within a complex academic medical environment.
This Manager role will establish and lead a centralized function responsible for:
- Oversight of professional coding-related denials across the Enterprise, including root cause analysis and resolution strategies
- Development and standardization of denial prevention workflows and appeal processes
- Identification of trends and collaboration with coding, education, CDI, and revenue cycle teams to address underlying issues
- Monitoring denial performance metrics and driving data-informed improvement initiatives
- Providing leadership and structure as denial-focused resources are formalized and expanded
This position ensures focused accountability for denial performance, strengthens alignment across coding and revenue cycle operations, and supports organizational goals related to revenue integrity and reimbursement optimization.
Candidates should be able to demonstrate:
- Expert knowledge of ICD-10-CM, CPT, HCPCS coding; Medicare and commercial payer rules and guidelines; and adjudication and appeals processes.
- Experience interpreting EOBs, remittance advice codes, payer policies, and medical billing workflows.
- Knowledge of revenue integrity, charge capture, and CDI concepts.
- Excellent analytical, organizational, and communication skills.
- Proficiency using dashboards or reporting tools (e.g., Excel, Power BI, Tableau).
- Experience using an EMR and billing platform (EPIC strongly preferred).
- Experience leading denials prevention initiatives and managing denial workflows in an academic medical center or large integrated healthcare system strongly preferred.
MINIMUM REQUIREMENTS:
Education: Bachelor's degree required. Significant (4+ years) experience
beyond the required experience indicated below may be accepted in lieu of the Bachelor's degree
Experience: 7+ years of previous coding experience, to include 2+ years of formal management experience required. Strong preference for formal management experience in revenue cycle operations, professional coding, or denials management
Licensure: Active coding certification through either AHIMA or AAPC required; CPB preferred
PHYSICAL DEMANDS:
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings, and programs.
The pay range for this role is $110,000.00 - $138,432.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.
Benefits- Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
- Paid Time Off, Long-term and Short-term Disability, Retirement Savings
- Health Saving Plans, and Flexible Spending Accounts
- Certification and education support
- Generous Paid Time Off
