Director, Denials

This is a fully remote position, open to applicants in Florida.

📋 Description

• Drive operational effectiveness within a specific function or workflow segment of the denials lifecycle.

• Take ownership of execution, throughput, cycle time, and quality outcomes at the functional level.

• Translate strategic objectives into consistent daily performance.

• Collaborate cross-functionally with Operations, Product, Finance, and Client Success to enhance workflows and address operational challenges.

• Deliver quantifiable enhancements in throughput, cycle time, quality, and productivity.

• Ensure clear ownership, accountability, adherence to processes, payer guidelines, and quality standards.

• Identify and eliminate blockers, bottlenecks, operational inefficiencies, and performance gaps.

• Lead and support the implementation of process enhancements, workflow modifications, tools, automation, and operational initiatives.

• Monitor performance trends and utilize data to prioritize actions and foster continuous improvement.

• Coach, develop, and provide support to Managers and/or frontline leaders.

• Promote accountability, engagement, and consistent performance management.

• Ensure that work is routed, prioritized, and executed according to workflow logic and business priorities.

• Make real-time decisions to address performance gaps, rebalance workloads, and sustain throughput.

• Support seamless transitions and alignment throughout the entire denials lifecycle.

⛳️ Requirements

• 7-10+ years of experience in Revenue Cycle Management, with familiarity in denial management, or a comparable combination of education and relevant experience.

• Proven experience leading teams in a metrics-driven, performance-oriented environment.

• Experience in managing work queues, workflows, and operational KPIs.

• Knowledge of payer guidelines, denial trends, and revenue cycle performance metrics.

• Experience in supporting process improvements or operational initiatives.

• Familiarity with practice management systems, EHRs, or payer portals.

• Strong operational leadership skills with an emphasis on execution, performance management, and results delivery.

• Demonstrated ability to manage and enhance workflow performance within a defined function or operational segment.

• Solid understanding of revenue cycle management and denial management processes, including payer dynamics and performance drivers.

• Ability to leverage data and KPIs to monitor performance, identify issues, and drive improvements.

• Strong problem-solving abilities with a knack for identifying root causes and implementing effective solutions.

• Experience in working cross-functionally to resolve issues and enhance workflow execution.

• Proven capability to lead teams and foster accountability, engagement, and performance.

• Excellent communication and organizational skills with the capacity to manage multiple priorities in a fast-paced environment.

• Adaptability to change and support in the implementation of new processes, tools, and workflows.

• Ability to link functional performance to broader business outcomes, such as throughput, cycle time, and revenue impact.

• Experience in working within or adjusting to tech-enabled, workflow-driven operating models.

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field is preferred.

• US remote-based employees must not work from outside the United States without prior written approval.

• Compliance with HIPAA, GLBA, FCRA, and other relevant laws; familiarity with the Code of Ethics and confidentiality obligations.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Flexible work arrangements and remote work options.

• Opportunities for professional development and career advancement.

• Generous paid time off and holiday leave.

• Retirement savings plan with company matching.

• Employee assistance programs and wellness initiatives.