Fraud Prevention Manager jobs in Flagstaff, AZ

Fraud Prevention Manager manages a team of analysts responsible for the detection, prevention, and mitigation of fraudulent transactions. Develops cross-functional initiatives to proactively detect and prevent fraud from occurring. Being a Fraud Prevention Manager approves and implements recommendations for process and procedure improvements. Reviews and implements best practices in the fraud prevention industry. Additionally, Fraud Prevention Manager ensures compliance with all relevant anti-fraud regulations and standards. Creates reports outlining trends, risks, and mitigation strategies. Requires a bachelor's degree. Typically reports to a director. The Fraud Prevention Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Fraud Prevention Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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System Manager Denials Prevention and Management
  • Northern Arizona Healthcare
  • Flagstaff, AZ OTHER
  • Overview

    Reporting to the System Director of Revenue Cycle Integrations & Denial Prevention, the Manager will lead and manage the department and teams responsible for addressing system-wide denials related to authorizations, notifications, non-coverage, medical necessity, level or care, and others as assigned. You will create an efficient and effective denials and appeals workflow, and optimize revenue recovery. This role works collaboratively across the organization to identify opportunities for workflow and process improvement, set goals, measure process effectiveness and productivity, and implement needed policies.

    Responsibilities

    Denials Management• Works collaboratively with leadership, medical staff, inter-disciplinary team members and revenue cycle entities to ensure optimal reimbursement and regulatory compliance

    • Leads multi-disciplinary work groups, manages denials management forums and communicates denial trends to Leadership, Case Management, Utilization Review, Managed Care, Revenue Cycle, Physician Advisors, Hospital Departments, and Clinics, etc.

    • Reviews and analyzes current audit information to educate colleagues both internal and external to the revenue cycle.

    • Identifies, and initiates clinical quality improvement initiatives focused on improving both clinical quality indicators/outcomes and financial metrics.

    People Management• Oversees System-wide Denial staff.

    • Performs or oversees personnel management functions. Provides training and support to Denials staff.

    • Hires, provides performance assessments and feedback, and develops staff.

    • Conducts timely performance reviews and provides on-going feedback.

    • Establishes and monitors individual and team goals and objectives.

    • Approves time and PTO requests.

    • Creates opportunities to celebrate the accomplishments of staff, providers and peers.

    • Challenges people, ideas, and opinions to develop the best possible support.

    • Quality management, workforce planning, recruiting, coaching and training.

    • Performance is demonstrated through continuous staff development, and employee engagement.

    Compliance and Safety• Interprets and implements complex rules and regulations governing insurance, appeal activities, trends, etc. to make recommendations

    • Monitors and tracks meaningful metrics to assess performance (effectiveness, efficiency) of denials management workflows and validates KPIs and triggers process improvement efforts pro-actively based on performance targets

    • Develops and manages initiatives to ensure the operations of the denials management teams is in line with organizational goals

    Qualifications

    EducationBachelor's Degree in realted healthcare field Preferred

     

    Certification & LicensuresN/A

     

    Experience• Minimum of seven years of progressive experience in appeal/denial management required.• Ability to analyze and resolve problems; manage multiple priorities; prepare reports; organize, direct and evaluate work of assigned staff; utilize a variety of electronic software applications including hospital financial management systems. Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.

  • 23 Days Ago

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Asset Protection/Loss Prevention
  • The Home Depot
  • Flagstaff, AZ FULL_TIME
  • Job Description The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and supporting safety and environmental program compliance in their ass...
  • 16 Days Ago

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Security loss prevention
  • Gecko Hospitality
  • Sedona, AZ FULL_TIME
  • Resort Director of Safety and Security $90,000 - $110,000 Sedona, AZ Our company is in search of a professional, customer-centric, organized Director of Safety and Security who shares our commitment t...
  • 1 Month Ago

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Workplace Wellness-Injury Prevention and Manual Therapy
  • DORN
  • Prescott, AZ CONTRACTOR
  • Company Overview:DORN Companies is an industrial injury prevention and ergonomics company passionate about reducing and eliminating employees’ pain and injuries by providing collaborative expertise to...
  • 1 Month Ago

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Manager
  • Dunkin' | Southpaw
  • Cottonwood, AZ FULL_TIME
  • As a Dunkin' franchisee, we are committed to our employees as much as we are committed to our customers. We value hardworking and enthusiastic employees and we make it a priority to ensure their succe...
  • 2 Days Ago

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Manager
  • Dunkin' - Franchisee Of Dunkin Donuts
  • Cottonwood, AZ FULL_TIME
  • In 1950, Bill Rosenberg opened the first Dunkin' shop in Quincy, Massachusetts. Dunkin' licensed the first of many franchises in 1955. It is now the world's leading baked goods and coffee chain, servi...
  • 2 Days Ago

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0 Fraud Prevention Manager jobs found in Flagstaff, AZ area

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Houseperson
  • Wyndham Hotels & Resorts
  • Flagstaff, AZ
  • ** Houseperson** Location: Flagstaff, AZ, US, 86001 Property Name: La Quinta by Wyndham Flagstaff Req Id: 19089 La Quint...
  • 3/29/2024 12:00:00 AM

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Assistant Store Manager - Sporting Goods
  • Country Supplier
  • Flagstaff, AZ
  • Who We Are: C-A-L Ranch Stores is a Ranch & Home Store AND SO MUCH MORE! Our company is full of craftsmen, marksmen, out...
  • 3/29/2024 12:00:00 AM

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Travel Nurse RN - Labor and Delivery - $1,907 per week
  • TRS Healthcare
  • Flagstaff, AZ
  • Nurses First Solutions is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Flagstaff, Arizona. J...
  • 3/29/2024 12:00:00 AM

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Experienced - 12 Volt Installation Technician / Car Stereo Installer
  • Sounds Good Mobile
  • Flagstaff, AZ
  • Job Description Job Description As a Car Stereo / 12V Installer at our company, you will be responsible for efficiently ...
  • 3/29/2024 12:00:00 AM

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Director of Development- Grand Canyon Trust
  • Chicha Collective
  • Flagstaff, AZ
  • Job Description Job Description NOTE: This hiring process is being done in collaboration with Chicha Collective, a recru...
  • 3/28/2024 12:00:00 AM

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Assistant Community Manager
  • Inspire Communities
  • Cottonwood, AZ
  • Job Description Job Description Company: For more than thirty years, Inspire Communities and its predecessor companies h...
  • 3/28/2024 12:00:00 AM

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DRUG-GEN MDSE/DEPT LEADER
  • Kroger
  • Flagstaff, AZ
  • Job Description Create an outstanding customer experience through exceptional service. Establish and maintain a safe and...
  • 3/26/2024 12:00:00 AM

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Driver-Class A CDL
  • Builders FirstSource
  • Flagstaff, AZ
  • Drive for BFS, the #1 name in the industry and America's largest supplier of building materials, value-added components ...
  • 3/25/2024 12:00:00 AM

Flagstaff is a city in and the county seat of Coconino County in northern Arizona, in the southwestern United States. In 2015, the city's estimated population was 70,320. Flagstaff's combined metropolitan area has an estimated population of 139,097. The city is named after a ponderosa pine flagpole made by a scouting party from Boston (known as the "Second Boston Party") to celebrate the United States Centennial on July 4, 1876. Flagstaff lies near the southwestern edge of the Colorado Plateau, along the western side of the largest contiguous ponderosa pine forest in the continental United Sta...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Fraud Prevention Manager jobs
$91,150 to $121,322
Flagstaff, Arizona area prices
were up 2.5% from a year ago

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