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Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.

All employees are eligible for medical coverage on their first day! In addition, upon hire all employees are eligible for a 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. Employees in a FT or PT status (40+ hours per pay period) will also be eligible for paid time off, life insurance, short term and long-term disability and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more! Coverage is available to employees and their qualified dependents in accordance with the plans. Benefits may vary based on state law.

The Authorization Denials Manager is responsible for the analysis, coordination, monitoring, education and support to Revenue Cycle related to the authorization denials and appeals program. The manager will work to ensure compliance with the appeals and denials processes throughout the Revenue Cycle departments. The manager will track appeals and denials data, noting trends, performing root cause analysis and identifying improvement opportunities. This position will also facilitate process standardization to promote improved outcomes, maximize resource utilization and improve organizational efficiencies.

• Manage the denials and appeals process for all authorization denials, including reviewing denial reasons, gathering necessary documentation, and preparing appeals
• Analyze authorization denial trends and identify opportunities for process improvement to prevent future denials
• Collaborate with providers, including physicians, nurses, and other clinical staff, to gather supporting documentation for appeals
• Communicate with insurance companies and third-party payers to ensure claims resolution and timely payment
• Monitor the status of appeals and provide regular updates to stakeholders on progress and outcomes
• Serve as a subject matter expert on insurance regulations, coverage policies, and reimbursement guidelines
• Develop and implement training programs for staff on denials management best practices and appeal strategies
• Maintain accurate records of denials, appeals, and outcomes for reporting and auditing purposes

This is not an all-inclusive list of this job’s responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.

Required:

• 5-7 years revenue cycle experience
• 3-5 years supervisor/manager experience
• High School Diploma/GED

Preferred:

• Bachelor's Degree