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virginiahealth

virginiahealth

Manager, Enterprise Professional Coding Denials

Company

virginiahealth

Role

Manager, Enterprise Professional Coding Denials

Location

Charlottesville, Virginia, United States of America

Job type

-

Found on Mokaru

2 days ago

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Salary

$110k - $138k/yearly

Job description

The Manager – Enterprise Professional Coding Denials is responsible for leading UVA Health’s professional coding denial prevention and resolution initiatives. This role oversees the full lifecycle of professional claim denials, ensuring appropriate coding, accurate reimbursement, and compliance with payer guidelines. The Denials Manager collaborates across the health system—including providers, coders, educators, clinical departments, and revenue cycle teams—to reduce avoidable denials, strengthen appeal strategies, and support organizational revenue integrity efforts.

This position serves as UVA Health’s subject matter expert for professional coding–related denials as well as payer policy interpretation and compliance and plays a key role in performance improvement within a complex academic medical environment.

This Manager role will establish and lead a centralized function responsible for:

Oversight of professional coding-related denials across the Enterprise, including root cause analysis and resolution strategies

Development and standardization of denial prevention workflows and appeal processes

Identification of trends and collaboration with coding, education, CDI, and revenue cycle teams to address underlying issues

Monitoring denial performance metrics and driving data-informed improvement initiatives

Providing leadership and structure as denial-focused resources are formalized and expanded

This position ensures focused accountability for denial performance, strengthens alignment across coding and revenue cycle operations, and supports organizational goals related to revenue integrity and reimbursement optimization.

Candidates should be able to demonstrate

Expert knowledge of ICD-10-CM, CPT, HCPCS coding; Medicare and commercial payer rules and guidelines; and adjudication and appeals processes.

Experience interpreting EOBs, remittance advice codes, payer policies, and medical billing workflows.

Knowledge of revenue integrity, charge capture, and CDI concepts.

Excellent analytical, organizational, and communication skills.

Proficiency using dashboards or reporting tools (e.g., Excel, Power BI, Tableau).

Experience using an EMR and billing platform (EPIC strongly preferred).

Experience leading denials prevention initiatives and managing denial workflows in an academic medical center or large integrated healthcare system strongly preferred.

MINIMUM REQUIREMENTS

Education: Bachelor's degree required. Significant (4+ years) experience beyond the required experience indicated below may be accepted in lieu of the Bachelor's degree

Experience: 7+ years of previous coding experience, to include 2+ years of formal management experience required. Strong preference for formal management experience in revenue cycle operations, professional coding, or denials management

Licensure: Active coding certification through either AHIMA or AAPC required; CPB preferred

PHYSICAL DEMANDS

This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings, and programs.

The pay range for this role is $110,000.00 - $138,432.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

Paid Time Off, Long-term and Short-term Disability, Retirement Savings

Health Saving Plans, and Flexible Spending Accounts

Certification and education support

Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment .

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