SHS-MGR-DENIALS

Company: Sparrow Health System
Location: Lansing
Posted on: January 16, 2022

Job Description:

Positions Location: Lansing, MI
Job DescriptionGeneral Purpose of Job:Provide leadership and direction for Sparrow Health System's denials avoidance functions. Areas of focus will include denials, denial write offs,appeals management, financial analysis of managed care contracts, and other clinically related denial issues.Essential Duties:This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Provide leadership for Sparrow Health System's Denial avoidance team.
• Monitor key performance indicators within span of control. Work with leadership and staff to develop and direct process improvement initiatives related to denial KPI's.
• Provide leadership in developing and improving caregiver engagement.
• Analyze denial and audit results to identify root cause issues and resolutions.
• Chair/ lead denials steering committee, and organize/lead various denials subgroups to meet denials goals.
• Establish policies and procedures to properly govern the denials avoidance team.
• Peforms interviewing, selecting, orienting, and training of staff within span of control.
• Insure that areas of responsibility follow the established Health System Compliance Plan initiatives.
• Assist other Clinical and Revenue Cycle leaders in generating, analyzing and interpreting data to support managed care payer contracts, payer scorecards, payment reform issues, and denial opportunities.
• Represent the Health System in its relationship with other health agencies, organizations, and groups dealing with government agencies and third party payers at State, National, and local health policy meetings.Job RequirementsGeneral Requirements
• Membership in Healthcare Financial Management Association.
  Work Experience --- Minimum 5 years experience in Revenue Cycle environments --- Experience in a leadership role - preferred
  Education
• Bachelor's Degree in Finance, Accounting, Business Administration, Healthcare Administration or related field.
  Specialized Knowledge and Skills --- Detailed knowledge of payer reimbursement methodologies and billing compliance rules. --- Ability to plan, organize, coordinate, direct and lead. --- Excellent communication skills (written, verbal, and listening).
  Sparrow Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

Keywords: Sparrow Health System, Lansing , SHS-MGR-DENIALS, Other , Lansing, Michigan