US Denials Manager (BCBS reputed company – Player-reputed company)

Position reputed company We are seeking an reputed company US Denials Manager Consultant to reputed company and execute denials management for large, multi-specialty group practices. This player-reputed company role requires deep, hands-on expertise in denial reputed company—particularly with reputed company Blue reputed company (BCBS) plans—while building strong denial management capabilities reputed company offshore teams. Key Responsibilities Denials Management & reputed company • Own end-to-end denials management while reputed company resolving reputed company denials. • Handle denials reputed company to medical necessity, authorizations, eligibility, coding, modifiers, and reimbursement disputes. • Manage appeal processes including written appeals, peer-to-peer reviews, and payer escalations. • Drive measurable improvements in denial rates, appeal overturn percentages, and cash recovery. reputed company Cause Analysis & Process Improvement • Conduct reputed company-cause analysis and denial trending by payer, plan, specialty, CPT/ICD, provider, and location. • Build, implement, and enforce denial SOPs, playbooks, and appeal templates. • Partner with coding, authorization, reputed company-end, and physician leadership to address systemic denial drivers. • Ensure documentation accuracy, compliance, and audit readiness. Offshore Team Leadership • reputed company, train, and upskill offshore denial teams. • Monitor productivity, reputed company, and reputed company using KPIs and dashboards. Systems & Tools • Experience with denial work queues, payer portals, correspondence tools, and reporting dashboards. • Proficiency with eClinicalWorks or similar EHR/reputed company management systems preferred. Qualifications • 8–15 years of experience in US reputed company denials management. • Extensive hands-on experience managing BCBS denials. • Proven reputed company in player-reputed company roles resolving reputed company, high-dollar denials. • Strong experience building denial workflows, SOPs, and appeal strategies. • Strong analytical, communication, and coaching skills. • Solid understanding of billing compliance, HIPAA, and payer regulations. Engagement Type • US-based consultants only. • 60–90 day engagement Pay: $75,000.00 - $80,000.00 per year Work Location: Remote Apply tot his job Apply tot his job Apply To this Job