Denials Prevention Manager

Ensemble Health Partners

Denial Prevention Manager optimizing revenue cycle operations for Ensemble Health Partners. Supervising denial prevention specialists and driving strategic initiatives while ensuring compliance with payer standards.

Posted 5/21/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $62,500 - $119,700 per yearWebsite

About the role

Key responsibilities & impact

The Denial Prevention Manager leads strategies and operations to minimize claim denials and maximize first-pass resolution across the revenue cycle, ensuring compliance with payer requirements and enterprise standards.
Supervise denial prevention specialists, monitoring KPIs such as denial rates and recovery timelines, and leveraging analytics to identify trends and optimize workflows.
Partners with Billing, Coding, Clinical Documentation, and Client Services teams to ensure accurate claim submission, resolve complex issues, and maintain payer relationships.
Acting as a strategic leader, this position establishes governance frameworks, enforces quality controls, and drives continuous improvement initiatives that enhance operational efficiency and client satisfaction.
Responsible for interviewing, hiring, staffing, training, performance management and development of staff.
Counsel and disciplines employees when necessary, in accordance with department and/or organizational policies.
Develops, updates and implements job standards, job duties, departmental policies and performance appraisals for all areas of responsibility.
Provides operational support to Service Line Analyst(s) and Supervisor(s)
Oversee documentation of trends denial prevention findings into defined templates or create reports or summaries as needed.
Perform reviews using all patient accounting, Host, Epic and related systems used across Ensemble Health Partners and summarizes trends concisely and actionably.
Assists in strategic planning and establishes departmental goals to optimize performance and meet budgetary goals while improving operations to increase Client satisfaction and meet the financial goals of the organization.
Creates materials and trains Service Line Analysts, revenue cycle site directors, committee members, and revenue cycle staff as necessary on denials-related trends and issues impacting assigned client(s) and operational area(s).
Performs other duties as assigned.
Travel to Client site(s) as needed.

Requirements

What you’ll need

Bachelor’s Degree or Equivalent Experience
Strong consideration given to CCS/COC/CIC and/or RN/LPN/BSN (does not need to be current)
Medicare and Medicaid audit experience required.
Proficient knowledge of Medicare, Medicaid and other third-party payer documentation, coding and billing regulations
Strong written and verbal communication skills to communicate in clear, concise terms to management at all levels and the ability to articulate complex regulatory information in layman's terms
Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements, to include the exploration, experimentation, and application of AI.

Benefits

Comp & perks

Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

denial preventionrevenue cycle managementKPI monitoringanalyticsclaim submissionperformance managementstrategic planningreportingcoding regulationsAI management

Soft Skills

leadershipcommunicationteam managementproblem-solvingtrainingcounselingcontinuous improvementclient satisfactionorganizational skillsinterpersonal skills

Certifications

Bachelor’s DegreeCCSCOCCICRNLPNBSN