Senior Director, Denials Management (Revenue Cycle)

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM™ intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers’ Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. 

Position Summary

The Senior Director, Denials is an integral leader within the Revenue Services Department responsible for daily oversight and growth of the department. The Senior Director, Operations will provide leadership, supervision and coaching to a team of people leaders. They will develop, implement and maintain a denials/appeals management program for all payer types. The Sr. Director, Denials will act as a subject matter expert in Denials while evaluating strategic and operational development of Denials products to enhance the company’s competitive strategy. The Sr. Director, Denials will develop and outline department processes improvements and training to ensure the department’s efficient operation, financial stability, and growth. They will manage, organize, and lead Denials based projects regarding multiple new and current clients concurrently as well as working with supervisors to forecast accurate monthly revenue projections to ensure company goals are met. The Sr. Director, Denials will manage all aspects of client projects, directly manage client contacts / client facing, manage risk, own issue resolution, and identify opportunities leading to high client satisfaction and revenue maximization. To fulfill this obligation, the Sr. Director will need to successfully manage project plans, resources, and clients.

Key Responsibilities

• Acts as a subject matter expert in EnableComp Denials related products.
• Conduct product opportunity research to determine efficacy and profitability based on cost models.
• Research and development of innovative products enabling EC to advance within the industry, increase profitability, and grow as a company.
• Act as a key resource during the implementation of the new products.
• Identify, research, and develop new business opportunities within the scope of the department.
• Assist with department’s business strategy alongside the Vice President, Complex Claims.
• Create and manage training materials and presentations to support departmental growth, best practices, and increased revenue.
• Participate and lead aspects of product implementations while identifying improvements and opportunities.
• Develop or enhance operational processes within the Denials Department to drive efficiency with focus on quality.  
• Assist with the creation, communication, and training of new department products, process changes, and operational best practices.    
• Create, define, and modify processes for general client denials inventory and performance management, communication, reconciliation processes, and client/executive denials reporting.
• Manage a team of CC Project Coordinators, responsible for hiring and staffing of this department as business needs dictate.
• Work closely with Analytics team to analyze incoming files for data integrity, revenue opportunity, and client feedback.
• Assist Implementation team with implementation/client onboarding, team member access related issues, and new client or product related projects.
• Communicate with EC team members to identify and define denial project related requirements and scope.
• Responsible for organizing and tracking escalated issues, including communicating action plans for resolution with senior management stakeholders and senior leadership at EnableComp.
• Act as liaison between Client and department for special projects, issue resolution, and any other client or department needs.
• Manage a portfolio of Client Project Dashboards, issue resolution, action plans and related processes.
• Lead Client performance reviews, quarterly business reviews, and related performance-based meetings via teleconference and/or onsite directly with decisionmaker-level executives.
• Other duties as assigned. 

Requirements & Qualifications

• Bachelor’s Degree preferred.
• Highschool diploma or GED required.
• Provide strategic direction and leadership to ensure the team meets client expectations.
• 10+ years’ experience in management or supervisory experience.
• 8+ years’ experience in healthcare field working.
• 7+ years’ of client facing/customer services experience,
• Comfortable understanding of insurance payer/provider claims processing,
• Equivalent combination of education and experience will be considered.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
• Load-balance departmental duties to establish the correct allocation of resources and accurate measurement of deliverables and program operational goals.
• Maximize efficiency and productivity through extensive process analysis and interdepartmental collaboration.
• Manage multiple teams by setting daily, monthly and strategic goals for assigned supervisors/managers.
• Ensure compliance and consistency with regulations and internal policies.
• Identify why/when/how to make up variances on best practice metrics, and report variances and action plans to Executive Management on a weekly basis.
• Maintain a current working knowledge of all related HIPAA regulations and ensures staff compliance to these requirements. This includes updating work processes, system capabilities, and policies and procedures as well as training staff on these requirements.
• Perform regular audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client.
• Strong working knowledge of data analysis and performance metrics using business management software.
• Extensive level of understanding of insurance payer/provider claim processing and subsequent data requirements.
• Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
• Regular and predictable attendance.
• Travel 10-15%; general office environment

Special Considerations & Prerequisites

• Practices and adheres to EnableComp’s Core Values, Vision and Mission.
• Proven ability to meet and/or exceed productivity targets and goals.
• Maintains stable performance under pressure or opposition.Handles stress in ways to maintain relationshipswith all stakeholders.
• Proven success in setting priorities for direct reports.
• Must be a self-starter and able to work independently without direct supervision.
• Proven written and verbal communication skills.
• Strong analytical and problem-solving skills.
• Proven experience working with external clients; strong customer service skills and business acumen.
• Ability to prioritize and manage multiple competing priorities and projects concurrently.
• Must be able to remain in stationary position50% of the time.
• Occasionally moves about inside the office to access office equipment, etc.
• Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer.

EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.

EnableComp recruits, develops and retains the industry's top talent.  As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.  We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies.  If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.

“I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.” – Revenue Specialist

“I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented an