Denials Management Lead

HealthAlliance of the Hudson Valley

Medicine and Health

West Nyack, NY - USA

Senior Specialist / Project Manager

Experteer Overview

In this role you drive denial prevention and resolution within the hospital revenue cycle. You will review denials, manage appeals, and collaborate with clinical and leadership to address root causes. You’ll lead education and process improvements to reduce future denials while ensuring compliant, timely collections. This position offers impact by shaping denial management practices and strengthening revenue integrity.

Responsibilities

Review medical necessity, respond to authorization concerns, and reconcile coverage-related issues
Evaluate initial denials and pursue appropriate review or appeals
Identify root causes such as documentation gaps or charge capture issues; communicate with clinical and revenue cycle leadership
Develop and implement staff education and process changes to prevent denials
Manage denial-related collections and accounts receivable activities to meet department requirements

Key requirements

5 years of direct experience in Hospital Billing, Follow-Up, Collections or Denials Management (preferred)
Ability to work independently and resolve denial problems
6–10 years of experience in healthcare billing or follow-up in lieu of education
Bachelor's Degree preferred

independence problem-solving communication with leadership denial management appeals process accounts receivable management

Description

In this role you drive denial prevention and resolution within the hospital revenue cycle. You will review denials, manage appeals, and coll…

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