Top candidates will have experience in one or more of the following:

- HEALTHCARE Revenue Cycle.

- Electronic transactions such as 837 (claims), 835 (remits), and 277 (claim status).

- Federal, State, and commercial regulations, policies, and healthcare billing workflows.

- Building of claims edits (working closely with IT).

- Understanding of basic coding or SQL. (technical role).

- Epic experience a big plus, but not required.

- Project management skills related to these areas.

This position is responsible for planning, directing and overseeing the operations and fiscal health of a revenue cycle business unit. This role is responsible for overseeing billing operations, denial avoidance strategy, regulatory compliance, and staff development within the revenue cycle. The position ensures accuracy, efficiency, and compliance in all billing and claims processes while driving continuous improvement, strategic alignment, and staff engagement across departments. This position has no responsibility for providing care to patients.

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Billing, Claims, and Denial Avoidance

• Analyze and implement standard/custom claim edits and workflows in compliance with organizational policies.
• Monitor billing and denial activities to ensure accuracy, timeliness, and adherence to payer requirements.
• Supervise billing processes and claim submissions, incorporating regulatory updates and payer-specific guidelines.
• Provide technical support and guidance to staff on billing procedures and payer protocols.

Compliance and Regulatory Oversight

• Track and resolve regulatory compliance issues and investigatory findings related to Medicare and Commercial payers.
• Maintain up-to-date knowledge of Federal, State, and insurance regulations impacting billing and reimbursement.
• Ensure compliance with institutional policies and external regulatory requirements.

Data Analysis and Performance Monitoring

• Lead initiatives to identify and resolve billing, denial, and compliance issues using data-driven insights.
• Design and manage performance metrics to evaluate insurance collection effectiveness and operational outcomes.
• Monitor and report on key performance indicators (KPIs) related to accounts receivable and revenue cycle efficiency.
• Collaborate with IT and analytics teams to enhance reporting tools and data transparency.

Strategic Planning and Process Improvement

• Research and recommend billing, collections, and denial prevention strategies.
• Contribute to strategic planning decisions affecting billing and collections operations.
• Oversee the timely collection of outstanding accounts receivable and recommend effective collection methodologies.
• Collaborate with internal departments and external payers to enhance processes and build strong partnerships.

Leadership and Staff Development

• Hire, train, and develop staff to ensure high performance and professional growth.
• Provide ongoing coaching, timely performance evaluations, and recognition to support team success and accountability.
• Actively engage staff with updates, involve them in decision-making and work teams, and foster a collaborative environment.
• Address conflicts proactively and work toward timely resolution.
• Build and maintain positive relationships with staff, peers, and leadership to support the organization’s mission, vision, and values.

Knowledge / Skills / Abilities

• Technical Expertise: Strong understanding of billing systems, claims processing, denial management, and reimbursement methodologies across multiple payer types.

• Regulatory Knowledge: In-depth familiarity with HIPAA, Medicare, Medicaid, and commercial payer regulations, as well as Federal and State healthcare billing requirements.

• Analytical Thinking: Ability to interpret complex data sets, identify trends, and develop actionable insights to improve financial and operational performance.

• Problem Solving: Skilled in identifying root causes of billing and denial issues and implementing effective, sustainable solutions.

• Communication: Excellent verbal and written communication skills, with the ability to convey complex information clearly and collaborate across departments.

• Leadership: Proven ability to lead, mentor, and develop high-performing teams while fostering a culture of accountability and continuous improvement.

• Project Management: Strong organizational and time management skills, with the ability to manage multiple priorities and meet deadlines in a dynamic environment.

• Collaboration: Ability to build and maintain effective working relationships with internal stakeholders and external payers.

• Technology Proficiency: Proficient in electronic health record (EHR) systems, billing software, and data analysis tools.

Qualifications

Required

• Bachelor’s degree in Business Administration, Healthcare Administration, or related field required.
• Minimum of 4 years of experience in revenue cycle management or related healthcare operations.
• 4+ years of more progressively responsible management experience.

Preferred

• Master’s degree in a related area, or equivalency.
• Experience working in an academic medical center or integrated health system preferred.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.