Senior Appeals & Denials Resolution Manager

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Appeals & Denials Resolution Manager based in the United States. As a Senior Appeals & Denials Resolution Manager, you will lead the development and execution of comprehensive payer appeals and denial resolution operations within an innovative healthcare environment. You will take ownership of complex reimbursement challenges, investigating difficult claims and developing compelling, evidence-based appeals to improve reimbursement outcomes. Working independently, you will engage directly with payer representatives, clinical reviewers, and decision-makers to resolve challenging cases. You will also establish scalable processes, quality standards, and performance metrics to strengthen operational efficiency. Leveraging AI-enabled technologies alongside human expertise, you will optimize workflows while maintaining accuracy, compliance, and accountability. This is an opportunity to play a strategic role in improving healthcare access and supporting the growth of digital health solutions.