Claims Resolution & Denials Manager
- Req #: 5307
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Address:
29777 Telegraph RdSouthfield,MI
- Date Posted: 8/28/2025
What you'll do...
The Claims Resolution & Denials Manager is responsible for the day-to-day operations of the denials prevention, appeals process and the creation of training materials for PSC team members. In addition, would collaborate in the training of providers and office staff on department functions.
This position will be required to identify areas of improvement, recommend & implement solutions and provide assistance, training and support to team members with new, revised or existing processes. Responsible to evaluate, coach and discipline staff as necessary, maintain up-to-date policies and procedures and job descriptions.
This position is located at the GEDC Practice Support Center in Southfield, MI and would require an on-site presence 5 days per week.
Duties and Responsibilities...
Supervisory Responsibilities...
What we require you have...
About GEDC...
Since 1982, Great Expressions has been at the forefront of dental innovation, setting the standard for exceptional care and unforgettable patient experiences. Now, we're entering a new era of transformation, and we want you to be a part of it. Our recently appointed leadership team brings over a century of collective dental expertise and is backed by dynamic investment support to pave the way for groundbreaking changes. We're channeling our resources and energy into revolutionizing our technology platform, expanding service offerings, and creating a personalized patient experience that goes beyond the expected. At Great Expressions, we're not just transforming dentistry; we're investing in the growth and development of our team. Join us and be a part of a career that blends innovation and professionalism, where your contribution shapes the future of dental excellence.
#IND8
The Claims Resolution & Denials Manager is responsible for the day-to-day operations of the denials prevention, appeals process and the creation of training materials for PSC team members. In addition, would collaborate in the training of providers and office staff on department functions.
This position will be required to identify areas of improvement, recommend & implement solutions and provide assistance, training and support to team members with new, revised or existing processes. Responsible to evaluate, coach and discipline staff as necessary, maintain up-to-date policies and procedures and job descriptions.
This position is located at the GEDC Practice Support Center in Southfield, MI and would require an on-site presence 5 days per week.
Duties and Responsibilities...
- Monitor team performance; quality & production to established goals & provide regular feedback to team members regarding performance
- Analyze and report on denial trends, associated corrective actions and effectiveness of actions
- Develop and communicate dollar opportunities per denial types, codes, provider and regions
- Provide training and re-training to staff and office staff as necessary
- Implementation of system changes to assist with prevention of denials at the provider, office and PSC level
- Detail knowledge of posting production adjustments, denial posting & processing, EOB interpretation and Billing submission, claims resolution and claim processing cycle.
Supervisory Responsibilities...
- Ensure all areas of responsibility are achieving expected targets
- Manage staff to expected productivity and quality outcomes
- Provide coaching, education, redirection and discipline as necessary
- Approval of PTO, Time-keeping, schedules
What we require you have...
- High School Diploma or GED equivalent required
- Bachelor degree in Business or Healthcare Management preferred but not required
- 2-3 years supervisory experience
- 5-7 year experience in accounts receivables preferred
- High level of detail and organizational skills
- Advanced knowledge of the revenue cycle
- Strong written and verbal communication & presentation skills
- Intermediate analytical skills and Practical application of process improvement, Six Sigma methodologies
- Ability to multi-task and follow-up timely on requests, emails, etc.
About GEDC...
Since 1982, Great Expressions has been at the forefront of dental innovation, setting the standard for exceptional care and unforgettable patient experiences. Now, we're entering a new era of transformation, and we want you to be a part of it. Our recently appointed leadership team brings over a century of collective dental expertise and is backed by dynamic investment support to pave the way for groundbreaking changes. We're channeling our resources and energy into revolutionizing our technology platform, expanding service offerings, and creating a personalized patient experience that goes beyond the expected. At Great Expressions, we're not just transforming dentistry; we're investing in the growth and development of our team. Join us and be a part of a career that blends innovation and professionalism, where your contribution shapes the future of dental excellence.
#IND8
