Career Opportunities

Assistant Director, Denials Management - Patient Financial Services - F/T - Days at Careers | UC Irvine Health - 12047

Updated: March 1, 2019
Job Family: Executive

Job Description & Salary Range

UC Title:                                     Director

Position Number:                      10007726

Reports to:                                 Sr. Director, Revenue Cycle

Working Title:                            Assistant Director, Denials Management

Cost Center:                              Patient Financial Services (8550)

Bargaining Unit:                       None

FLSA:                                          Exempt

Job Code:                                  0245

Date Created:                            01/22/2019

Shift:                                           Day Shift

Hours:                                         40.00


Position Summary: 

Responsible for planning, directing and overseeing all aspects of assigned Patient Financial Services units, including, but not limited to, non-governmental and government denials, including commercial, managed care, government managed care, ERISA plans and all others. Ensures standards of unit operations are in compliance with all state and federal healthcare regulatory agencies. Incumbent has overall responsibility for training, unit performance, resolution of operational and personnel issues, evaluations, hiring, and disciplinary action. Participates on organizational performance improvement projects. Analyze Denial trends and publish organizational reports to improve first pass yield. Serves as a role model and resource to colleagues, staff, and others. Interacts with all levels within the organization, including senior leaders, managers, directors as well as insurance companies, third party payers, vendors and regulatory agencies.


Required Qualifications:

Ability to maintain a work pace appropriate to the workload

Ability to motivate staff to achieve desired results

Bachelor's Degree in related field

Demonstrated experience building competency and developing skills of others

Detailed understanding of billing technical elements such as standard forms and data elements, coordination of benefit and third party liability billing and collection, electronic billing, data edit programs, reimbursement methodologies such as Diagnosis Related Groups (DRGs), Case Rate, Percent of Charges, capitation.

Excellent written and verbal communication skills in English

Extensive knowledge of governmental compliance rules and issues as it pertains to health care billing, collection and other reimbursement.

Minimum 5 years in a leadership/managerial position in a revenue based, health care related industry such as admissions, registration, billing/payor  or contracting.

Minimum 7 – 10 years’ experience in hospital patient account services.

Must have experience in working with contracts, applying terms and conditions to claims and performing split billing as required by Contracted Payers and DOFRs.

Must possess the skill, knowledge and ability essential to the successful performance of assigned duties

Self- directed and organized with superior analytical and problem-solving skills.

Sound understanding of Joint Commission and other applicable regulatory requirements to be able to monitor for compliance

Thorough knowledge of healthcare billing, finance and compliance and strong understanding of facility billing systems.

Working knowledge of billing commercial claims, workers compensation, managed care and all other third party payers.

Working knowledge of billing, follow up and denial management of commercial claims, workers compensation, managed care and all other third party payers.


Preferred Qualifications:

Experience in PFS Operations, University and medical center organizations, policies, procedures and forms

Knowledge of University and medical center organizations, policies, procedures and forms

Master’s degree in Health Care Management, Business, Finance or Accounting

Prior management experience of union-represented staff


Physical, Mental & Environmental Demands:

To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.





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