The University of Texas Southwestern Medical Center
Manager, Hospital Denials
The University of Texas Southwestern Medical Center, Dallas, Texas, United States, 75215
Job Description – Manager, Hospital Denials (904710)
WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas‑Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world‑renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas‑Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on‑site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you’ll discover a culture of teamwork, professionalism, and a rewarding career!
JOB SUMMARY The
Manager of PFS Revenue Cycle Operations
AKA Hospital Denials Manager plays a pivotal role in the hospital’s revenue cycle by overseeing and optimizing the resolution of technical insurance claim denials and insurance follow‑up. This position manages three supervisors and a team of 35 staff members, ensuring efficient workflows, staff engagement, and adherence to best practices in denials management. The successful applicant is responsible for identifying root causes of technical denials, developing strategies to prevent future occurrences, and driving initiatives that reduce accounts receivable balances and improve cash flow. Given our continued focus on automation and digital transformation, we strongly prefer candidates with experience leveraging AI tools and bot‑enabled workflows to enhance denials management and overall revenue cycle efficiency.
Key Responsibilities
Strong experience with EPIC Resolute—particularly in Rev Cycle workflows— is highly preferred for this role.
Leadership and Team Management
Technical Denials Management
Operations Oversight
Technology and Innovation
Stakeholder Collaboration Work From Home (WFH): This is a WFH position. Applicant must live in Texas; the Greater DFW area is preferred. Additional details will be discussed as part of the interview process.
Shift 8 am–5 pm, Monday through Friday
BENEFITS
PPO medical plan, available day one at no cost for full‑time employee‑only coverage
Paid Time Off, available day one
Retirement Programs through the Teacher Retirement System of Texas (TRS)
Paid Parental Leave Benefit
Wellness programs
Tuition Reimbursement
Public Service Loan Forgiveness (PSLF) Qualified Employer
Experience
5 years of hospital billing/operations to include federal, state, third‑party payors, research & transplant.
3 years of progressive supervisory/management experience with extensive knowledge of patient financial systems and processes including the healthcare revenue cycle, coding & billing compliance.
Proven record of identifying PI opportunities.
Requires strong negotiating, analytical & organizational skills as well as the ability to be flexible with changing needs & deadlines; the ability to interact & communicate both verbally & in writing with all levels of associates, management, & patients.
JOB DUTIES
Demonstrate continuous performance improvement in targeted areas of responsibility in alignment with the overall annual Hospital performance improvement targets. Manages daily operation of all Hospital Billing to ensure all charges are processed and billed in a timely manner to include Federal, State, and Third-Party Payors. (Billing and Collections of all Federal/State Payors i.e. Medicare/Medicaid). Responsible for daily exporting of claims from billing system to claim editor. Daily reconciliation between systems. Manages research and client billing & collections. Maintaining appropriate fee schedules. Manages billing/collection of Solid Organ & BMT services to include acquisition, pre/post-transplant. Manages Special Billing protocols to include package plans, self-pay, intl. patient billing, purchased services, workers comp & occupational billing, & other clinical departments, etc. Maintains appropriate fee schedules.
Coordinates all workflow issues and accounts concerns with Supervisors, peers, and leadership. Ability to properly delegate and prioritize work demands to meet or exceed financial goals and objectives of the department. This includes monitoring quality and quantity of work, performing Quality Reviews (QA's).
Manages, trains, and structures staff to achieve the quality and quantity of work and service provided by team to ensure team meets production, billing and cash goals set for the department. Ensures system work lists and settings are providing the best work source for staff. Conducts meetings and works with staff identifying payor reimbursement issues. Assist in performing analysis to determine root causes (payor or hospital), for payment variance issues and resolution.
Analyzes, recommends, & implements policies & procedures as needed to maximize reimbursement for services rendered in compliance with established government & third‑party guidelines. Close collaboration with hospital department managers to ensure timely charge submittal. Close collaboration with HIM/Coding Audit & Denial teams.
Acquires and maintains thorough knowledge of Federal & State Legislative & Administrative action affecting reimbursement; disseminates acquired knowledge to leadership. Risk Reporting monthly as outlined by Office of Compliance.
Audits posting of payments for purchased services, client & research billing. Coordinates all workflow issues & account concerns with PFS leadership.
Performs other duties as assigned.
SECURITY AND EEO STATEMENT Security This position is security‑sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal‑opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
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JOB SUMMARY The
Manager of PFS Revenue Cycle Operations
AKA Hospital Denials Manager plays a pivotal role in the hospital’s revenue cycle by overseeing and optimizing the resolution of technical insurance claim denials and insurance follow‑up. This position manages three supervisors and a team of 35 staff members, ensuring efficient workflows, staff engagement, and adherence to best practices in denials management. The successful applicant is responsible for identifying root causes of technical denials, developing strategies to prevent future occurrences, and driving initiatives that reduce accounts receivable balances and improve cash flow. Given our continued focus on automation and digital transformation, we strongly prefer candidates with experience leveraging AI tools and bot‑enabled workflows to enhance denials management and overall revenue cycle efficiency.
Key Responsibilities
Strong experience with EPIC Resolute—particularly in Rev Cycle workflows— is highly preferred for this role.
Leadership and Team Management
Technical Denials Management
Operations Oversight
Technology and Innovation
Stakeholder Collaboration Work From Home (WFH): This is a WFH position. Applicant must live in Texas; the Greater DFW area is preferred. Additional details will be discussed as part of the interview process.
Shift 8 am–5 pm, Monday through Friday
BENEFITS
PPO medical plan, available day one at no cost for full‑time employee‑only coverage
Paid Time Off, available day one
Retirement Programs through the Teacher Retirement System of Texas (TRS)
Paid Parental Leave Benefit
Wellness programs
Tuition Reimbursement
Public Service Loan Forgiveness (PSLF) Qualified Employer
Experience
5 years of hospital billing/operations to include federal, state, third‑party payors, research & transplant.
3 years of progressive supervisory/management experience with extensive knowledge of patient financial systems and processes including the healthcare revenue cycle, coding & billing compliance.
Proven record of identifying PI opportunities.
Requires strong negotiating, analytical & organizational skills as well as the ability to be flexible with changing needs & deadlines; the ability to interact & communicate both verbally & in writing with all levels of associates, management, & patients.
JOB DUTIES
Demonstrate continuous performance improvement in targeted areas of responsibility in alignment with the overall annual Hospital performance improvement targets. Manages daily operation of all Hospital Billing to ensure all charges are processed and billed in a timely manner to include Federal, State, and Third-Party Payors. (Billing and Collections of all Federal/State Payors i.e. Medicare/Medicaid). Responsible for daily exporting of claims from billing system to claim editor. Daily reconciliation between systems. Manages research and client billing & collections. Maintaining appropriate fee schedules. Manages billing/collection of Solid Organ & BMT services to include acquisition, pre/post-transplant. Manages Special Billing protocols to include package plans, self-pay, intl. patient billing, purchased services, workers comp & occupational billing, & other clinical departments, etc. Maintains appropriate fee schedules.
Coordinates all workflow issues and accounts concerns with Supervisors, peers, and leadership. Ability to properly delegate and prioritize work demands to meet or exceed financial goals and objectives of the department. This includes monitoring quality and quantity of work, performing Quality Reviews (QA's).
Manages, trains, and structures staff to achieve the quality and quantity of work and service provided by team to ensure team meets production, billing and cash goals set for the department. Ensures system work lists and settings are providing the best work source for staff. Conducts meetings and works with staff identifying payor reimbursement issues. Assist in performing analysis to determine root causes (payor or hospital), for payment variance issues and resolution.
Analyzes, recommends, & implements policies & procedures as needed to maximize reimbursement for services rendered in compliance with established government & third‑party guidelines. Close collaboration with hospital department managers to ensure timely charge submittal. Close collaboration with HIM/Coding Audit & Denial teams.
Acquires and maintains thorough knowledge of Federal & State Legislative & Administrative action affecting reimbursement; disseminates acquired knowledge to leadership. Risk Reporting monthly as outlined by Office of Compliance.
Audits posting of payments for purchased services, client & research billing. Coordinates all workflow issues & account concerns with PFS leadership.
Performs other duties as assigned.
SECURITY AND EEO STATEMENT Security This position is security‑sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal‑opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
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