Associate Director, Denial Prevention

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Closing Date:

11/17/2025

Type of Position:

Senior Professional Staff - Operations

Job Type:

RegularNo

Institution Name:

University of Arkansas for Medical Sciences

The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education research and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization focused on improving patient care and the lives of Arkansans.

UAMS offers amazing benefits and perks (available for benefits eligible positions only):

• Health: Medical Dental and Vision plans available for qualifying staff and family
• Holiday Vacation and Sick Leave
• Education discount for staff and dependents (undergraduate only)
• Retirement: Up to 10% matched contribution from UAMS
• Basic Life Insurance up to $50000
• Career Training and Educational Opportunities
• Merchant Discounts
• Concierge prescription delivery on the main campus when using UAMS pharmacy

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position please click theApply link/button.

The University of Arkansas is an equal opportunity institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of any category or status protected by law including age race color national origin disability religion protected veteran status military service genetic information sex sexual orientation or pregnancy. Questions or concerns about the application of Title IX which prohibits discrimination on the basis of sex may be sent to the Universitys Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.

Persons must have proof of legal authority to work in the United States on the first day of employment.

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Department:

FIN CORE RI Revenue Cycle Analysis

Departments Website:

Summary of Job Duties:

Associate Director Denial Prevention/Reimbursement is responsible for the analysis interpretation and identification of insurance denials and charge capture related performance variations and opportunities. This position develops mitigation strategies and oversees and coordinates the execution of denial prevention and reduction projects collaborating with Leadership of key areas including but not limited to Accounts Receivable HIM Coding Patient Access and Clinical operations. This position directs charge related improvement efforts to achieve operational efficiency by implementing charge capture and reconciliation best practices to ensure maximum reimbursement and improve operational performance for hospital and professional services. Responsible for working with hospital and clinical departments to develop and execute charge capture and reconciliation processes that support operational efficiency ensure revenue optimization and minimize missed charging opportunities. This position is responsible for managing revenue cycle analysts and charge capture analysts and oversees the Clinical Trial claims up to billing ready including clinical trial calendars and two-tier review. Position is responsible for Revenue Guardian checks and sits on the charge master committee.

Qualifications:

• Bachelors degree in business nursing or related field with 5 years of experience providing consultation reporting analysis and/or dashboard development for revenue focused departments/service lines in a Healthcare provider setting. Management of a clinical area with reporting responsibilities or an equivalent combination of education and relevant experience.
• Proficient computer skills; MS Office including Word PowerPoint Excel and Outlook; Windows operating system and internet.
• Experience and proven success in practices procedures and concepts of the healthcare revenue cycle and its component operations including billing collections charge capture contractual adjustments third-party reimbursements and cash management.
• Proficiencies Advanced knowledge of revenue cycle processes and hospital/professional billing to include CDM UB04 Remittance Advices and 1500 claim form. Advanced knowledge of code data sets to include CPT HCPCS and ICD 10. Advanced knowledge of NCCI edits and Medicare LCD/NCDs. Comprehensive understanding of reimbursement methodologies to include DRG OPPS professional and facility billing. Ability to review analyze and interpret managed care contracts billing guidelines and state and federal regulations.
• Abilities: Due to its service focus this position requires strong interpersonal and communication skills well-developed analytic and organizational skills critical thinking and the ability to meet deadlines while influencing but not directly managing the work of others.

Preferred Qualifications:

• 7 years of experience providing consultation reporting analysis and/or dashboard development for revenue focused service lines in a Healthcare provider setting.
• RN CCS CPC CPA.
• Understanding of CPT/HCPCS codes payer regulations and payer reimbursement.
• Data Visualization experience utilizing Power BI.
• Working knowledge of Epic HB Resolute and PB Resolute.
• Working knowledge of Epic Slicer Dicer.

Additional Information:

Develop and execute a denial prevention plan that anchors denials resolution processes in the analyses of core analytics identifying root causes and identifying proactive and sound approaches to reducing denials.
Promote collaborative practices with Revenue Cycle stakeholders and facilitate data sharing providing insight into focus areas concentrated denial prevention and management efforts; identify and communicate payer-specific issues for escalation.
Disseminate information on the impact of changes to government and third-party payer regulations and/or requirements to clinical departments coding billing Revenue Cycle management and staff.
Create a consolidated denial prevention structure with monitoring; develop a methodology and committee structure to manage performance of the denial prevention function and govern operational changes to prevent future denials; analyze denial trends and coordinate mitigation and denial prevention activities.

Devise new methods procedures and approaches to prevent denials and to introduce and gain support for process improvement.
Charge Master: represent Denial Management as a member of the CDM committee; request charge modifications and Medicaid charge rolling logic based on new charge set up; monitor and report pharmacy charging issues related to codes quantity and pricing to Willow IP team as needed by CDM Committee; work with hospital and clinical departments to develop and execute charge capture and reconciliation processes that support operational efficiency ensure revenue optimization and minimize missed charging opportunities.
Clinical Trials: Collaborates with outpatient clinical areas to clarify coding-related issues in documentation; contacts HIM to resolve coding issues which may impact bill generation and/or payment; coordinate clarification of inconsistencies between approved procedures rendered and procedures in the research budget; review research audits/reports for accuracy and compliance; provide oversight for building clinical trial/research billing calendars in Proof of Concept (EPIC build environment module). Management of this task includes review of EAP and PB charge codes that are included in the approved CLARA budget. Ensure all associated charge codes are assigned to the correct protocol timeline (phase or arm) in the treatment plan where the clinical orders are created.
Unit management: Read analyze and interpret contract language in relation to expected reimbursement compliant billing practices and clinical trial calendars; prepare clear complete and concise records reports summaries analysis evaluations and recommendations for denials. Develop statistical data for upper management to assess and determine issues that impact revenue; remain current with the latest developments advancements and trends in Revenue Cycle; conduct charge reviews and claim audits to avoid loss of revenue; responsible for billing compliance regulations. Identify research communicate and resolve errors related to coding charge capture billing insurance verification late charges workflows and procedures. Develop process improvements to reduce errors related to coding charging billing and late charges; manage daily operations of the Revenue Support Unit; define short and long term goals recommend and implement corrective action to enhance the ability of the unit to meet its goals; manage and support various roles from entry level to professional; hire evaluate coach counsel discipline and terminate staff as needed; develop and conduct ongoing training for unit staff.
Participate in Leadership Development Activities; implement strategies and processes to improve employee morale and performance; provide ongoing feedback regarding productivity and quality.
Other duties as assigned.

Salary Information:

Commensurate with Education and Experience

Required Documents to Apply:

List of three Professional References (name email business title) ResumeProof of Veteran Status

Special Instructions to Applicants:

Please contact for any recruiting relatedquestions.

All application materials must be uploaded to the University of Arkansas System Career Site

Please do not send to listed recruitment contact.

Pre-employment Screening Requirements:

Criminal Background Check

This position is subject to pre-employment screening (criminal background drug testing and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity. The information obtained in these reports will be used in a confidential non-discriminatory manner consistent with state and federal law.

Constant Physical Activity:

Feeling Grasping Hearing Manipulate items with fingers including keyboarding Sitting Talking

Frequent Physical Activity:

Repetitive Motion

Occasional Physical Activity:

Crouching Lifting Pulling Pushing Reaching Standing Walking

Benefits Eligible:

Yes