Denials Management Manager Recruiters

What do we check before you see anyone?

Denial classification: Ask, “How would you validate a report showing a rise in authorization denials?” Look for claim-level sampling, reason-code review, and checks for reporting changes before conclusions. Appeal discipline: Ask, “What must an appeal file contain before submission?” Useful answers include the denial notice, relevant records, payer-specific instructions, submission deadline, and proof of delivery.

• Queue management: Ask, “How do you assign cases when deadlines and dollar values conflict?” Look for explicit rules covering filing limits, recovery prospects, staff skills, and escalation.
• Root-cause follow-through: Ask, “How would you test whether a registration correction reduced denials?” Listen for a defined claim population, comparable periods, and checks that another denial category did not absorb the problem.
• Reporting judgment: Ask, “What would you show leadership besides recovered dollars?” Strong answers distinguish denial volume, claim age, appeal outcomes, repeat causes, and work awaiting another department.
• Staff coaching: Ask, “How would you review an analyst’s unsuccessful appeals?” Look for file review and specific feedback on evidence, deadlines, and payer reasoning, not pressure to submit more letters.

Which mistakes stall the search?

Do not hire for collections experience without testing appeals work. Account follow-up does not show whether someone can build a defensible appeal or challenge an incorrect payer decision. Do not assign prevention goals without naming department owners. Specify who changes registration practices, authorization checks, coding edits, and documentation handoffs.