System Director Claim Denials, Revenue Cycle Accounts Receivable

It's more than a career, it's a calling.

MO-REMOTE

Worker Type:

Regular

Job Highlights:

Additional Job Description

Named 150 Top Places to Work in Healthcare 2024 - Becker's Healthcare 
Named One of the Diversity Leaders 2024 – Modern Healthcare 
Named One of America's Greatest Workplaces for Diversity 2024 - Newsweek
Named One of America's Greatest Workplaces for Women 2024 – Newsweek
Named One of America’s Greatest Workplaces for Job Starters 2024 – Newsweek

SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization’s 40,000 team members and more than 13,900+ providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve.

With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 12 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves.

This position IS remote work eligible. SSM Health currently offers remote work within the states of MO, WI, IL, OK, AL, FL, GA, IA, IN, KS, KY, LA, MI, NC, SC, TN, TX, UT, VA, WV.

To request additional information, confidentially submit your interest, or nominate a fellow colleague, please contact:

Angela Jones
Executive Talent Partner
Angela.Jones1@ssmhealth.com

#LI-Remote
 

Job Summary:

Directs, coordinates and oversees denial activities within the Hospital or Medical Group revenue cycle areas. The scope of responsibility is all post-billed denials (inclusive of clinical denials). Engages with key leadership including regional leaders to identify and correct root cause of denied claims through process improvements, set goals, measure process effectiveness and identify any need for policy and procedure updates.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Directs managers and team responsible for identifying denial and disputed payment process breakdowns. Creates a culture in alignment with mission and values, fostering individual motivation, teamwork and high levels of performance and accountability utilizing a participative management style to ensure staff retention and engagement.
• Understands complexities involved in supporting denials activities spanning multiple states, regional health ministries, payer environments, and technologies to direct teams accordingly to achieve high performance and resolution on trends.
• Demonstrates strong management skills that emphasize team building and strong leadership with the ability to provide clear direction to the department, while also functioning as an individual contributor to achieve goals. Lead projects to improve denial claim performance, compliance and efficiency within the denials process and structures. Identifies action plans to improve the quality of services in a cost-efficient manner and facilitates plan implementation.