Parkland Health · 2 days ago
Mgr., PFS Denials/Collections
Dallas, TX
Full-time
Onsite
Senior Level
5+ years expParkland Health is seeking a Denials/Collections Manager to oversee and manage all processes related to Denials Management in various healthcare settings. The role involves ensuring efficient denial resolution, collaborating with clinical leaders, and implementing strategies to improve revenue recovery and prevent future denials.
CommunitiesHealth CareHospitalMedicalNon ProfitWellness
Responsibilities
The manager will be responsible for implementing short and long-term plans and objectives to improve revenue and manage overall denials trends
Working with insurance companies to identify reasons for denied payment of services
Work with patient Access, Coding, Billing ,Follow-Up and Clinical areas to identify, correct, and reduce denials trends related to their respective departments
They will empower staff to develop methods of process improvement, including planning, setting priorities, conducting systematic performance assessments, implementing improvements based on those assessments and maintaining achieved improvements
Coordinate with the Care Management Appeals team to ensure a smooth workflow is developed, implemented, and maintained for addressing medical necessity denials. As well as support payer relationships as needed
Maintain denial inventory, appeals and follow up work daily to ensure timely appeals, rebills, and account reviews
Counsel staff with disciplinary and productivity issues
Contact insurance payers via telephone on aged/delayed/high dollars claims for resolution escalating as needed
Assist with the onboarding and training of all new hires
Communicates with all parties in a professional manner and provides explanations regarding the denial inventory
Ensure confidentiality of all patient accounts by following HIPAA guidelines
Adheres to compliance of CMS and other payer guidelines
Responsible for being aware of the current department policies and procedures
Review and follow adjustment requests and explanations timely and identified
Meet or exceed quality and quantity benchmark targets as established by management (Productivity, Cash Collections, Past Due Follow Up) or other key performance indicators
Communicate daily with upper management, patient access, case management, denial staff and other department heads regarding payor denial trends identified
Assist denial team with resolution of aged difficult claims promptly
Provide feedback and training to the denial team timely
Flexibility to assist with appeals, denial inventory, and follow-up based on need regardless of payer
Maintain complete and accurate follow up actions in the patient accounting system
Establishes and maintains insurance payor, employer, vendor and provider representative relationships including the coordination of meetings to improve dialog and processes
Maintains a working knowledge of insurance carriers, payers and processes utilized within the revenue cycle
Ensure all processes and payment compliance policies are followed according to but not limited to audit requirements
Timely and consistently reports project status to upper management/leadership
Assist upper management/leadership in the development of staff, plans and goals
Participants in all educational activities, and demonstrates personal responsibility for job performance. Organizes work/resources to accomplish objectives and meet deadlines
Maintains a professional image and provides excellent customer service
Attends department meetings and education sessions
Meets/exceeds performance expectations within required time frames
Practices and adheres to the Code of Conduct philosophy and Mission and Values statement
Working knowledge of all facets of insurance claim filing, requirements and regulations
Qualification
Required
BA/BS Degree or higher in education, business administration, health administration or finance preferred or related work experience
Must have five years of Patient Financial Services or Coding experience, to include three to five years of experience in analysis and resolution of hospital denials and two years of experience in a lead role
Must have experience with interpreting Medical Documentation and constructing effective appeal letters to overturn denials
Must have strong working knowledge of medical terminology and strong knowledge of HCPCS Codes and ICD-10 Codes
Must possess an expert level knowledge of PFS operations, including operations in a hospital healthcare environment
Must be able to prioritize efforts to achieve strategic goals
Must have excellent verbal and written communication skills
Must be customer service oriented
Must be able to think creatively and strategically in developing and implementing management procedures, goals and objectives
Company
Parkland Health
Parkland Health first opened its doors in 1894 and is now one of the largest public hospital systems in the country.
10001+ employees
H1B Sponsorship
Parkland Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (2)
2022 (2)
Funding
Current Stage
Late StageLeadership Team
Frederick Cerise
President and Chief Executive Officer
Richard Humphrey
Executive Vice President and Chief Financial Officer
Recent News
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