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Methodist Health System

Nonprofit, faith-based integrated health system

Manager Professional Billing & Denial Recovery

Accounts Payable/ReceivableConfirmed live in the last 24 hours
Full-timeDallas, TX, USANo salary listed

About the Job

Requirements

  • A bachelor's degree in Healthcare Administration, Business, or a related field is required.
  • At least 5 years of experience in physician billing, revenue cycle management, or payer relations is required.
  • At least 3 years of direct leadership experience is required.
  • In-depth understanding of CPT/HCPCS/ICD-10 coding, payer-specific requirements, and CMS guidelines for physician services is required.
  • Epic experience is required.

Responsibilities

  • Lead all post-bill follow-up and denial resolution activities across all payers, ensuring timely resolution and maximum reimbursement for multi-specialty physician services.
  • Direct the appeals and reconsideration process, including root cause analysis, persuasive appeal writing, and submission accuracy.
  • Collaborate with Revenue Integrity and Coding teams to ensure accurate documentation, reduce revenue leakage, and ensure compliant charge capture.
  • Oversee Epic workqueue utilization, provide optimization feedback, and partner with IT to support performance improvement.
  • Manage a team of AR staff, including one Team Lead, focusing on team coaching, performance monitoring, productivity tracking, and staff development.
  • Conduct denial trend analysis and lead cross-functional discussions to resolve clinical, documentation, or billing workflow barriers.
  • Support AR goals, denial recovery metrics, and process improvement initiatives in partnership with the Director of Physician Revenue Optimization.
  • Participate in enterprise revenue cycle meetings, peer manager forums, and professional development efforts.
  • Contribute to cultural engagement, team-building initiatives, and talent development in alignment with Methodist Health’s leadership standards.
  • Oversee AR Specialists and a Team Lead; set and achieve performance goals by fostering teamwork and effective communication and by moving conflict toward collaboration within the Central Business Office.
  • Monitor and improve efforts to reduce accounts receivable according to goals established by MHS Administration.
  • Monitor work quality and proactively review trends and variances that may delay reimbursement.
  • Work with the Director to prioritize departmental initiatives and develop, implement, monitor, and communicate annual goals and objectives.
  • Use knowledge of budgets and performance standards for the area of responsibility to evaluate cost-saving and quality-improvement opportunities.
  • Interact with Human Resources on hiring, training, coaching, and counseling employees in the area of responsibility.

Desired Qualifications

  • A master's degree is preferred.
  • Experience with denial management systems and reporting tools is preferred.
  • Certification through HFMA, AAHAM, or Epic (PB Resolute or Claim Edit) is preferred for new hires and encouraged for incumbents.

About the Company

Methodist Health System

Nonprofit, faith-based integrated health system

Methodist Health System operates a nonprofit, faith-based network of hospitals and physician clinics across Dallas-Fort Worth, offering primary care, cardiology, orthopedics, women's health, gastroenterology, and emergency care. Its network includes several medical centers and Methodist Medical Group's clinics. What sets Methodist Health System apart is its covenant tie to the North Texas Conference of the United Methodist Church and its sizable charity care commitment. The goal is to improve and save lives through compassionate, quality healthcare.

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