Fraud Prevention Manager jobs in Aurora, CO

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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Division Denial Prevention Manager
  • HealthOne
  • Denver, CO FULL_TIME
  • Salary Estimate: $76689.60 - $115065.60 / year
    Learn more about the benefits offered for this job.

    The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

    Introduction

    Want to join a team of daring managers who care without reservations or limits? Our HealthOne team is looking for a Division Denial Prevention Manager. HCA Healthcare is an advanced healthcare network that has committed up to $300 million to our incredible team members over the course of three years.

    Benefits

    HealthOne, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

    • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
    • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
    • Free counseling services and resources for emotional, physical and financial wellbeing
    • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
    • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
    • Family support through fertility and family building benefits with Progyny and adoption assistance.
    • Referral services for child, elder and pet care, home and auto repair, event planning and more
    • Consumer discounts through Abenity and Consumer Discounts
    • Retirement readiness, rollover assistance services and preferred banking partnerships
    • Education assistance (tuition, student loan, certification support, dependent scholarships)
    • Colleague recognition program
    • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
    • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

    Learn more about Employee Benefits

    Note: Eligibility for benefits may vary by location.


    HCA Healthcare is committed to research and clinical protocols. Do you want to impact standards of care and save lives across the country? Apply today to our Denial Prevention Manager and be a part of the innovation of ideas.

    Job Summary and Qualifications

    The Denial Prevention Manager works in collaboration with the Division Denial Manager, primarily focusing on identifying trends and action plans to mitigate loss due to denials, governmental denials or other payer/regulatory opportunities. The Denial Prevention Manager fosters effective communications among the division, hospitals, and all disciplines. This role requires project management, analytic skills and data reporting capability to provide denial prevention strategies through use of multiple HCA databases. The Manager champions HCA’s strategy and company/division/facility initiatives to ensure short and long-term objectives are operationalized within Continental Division hospitals. The Manager will identify opportunities for improvement and facilitate process standardization to promote improved outcomes, maximize resource utilization, and improve organizational efficiencies. This position must travel to and from locations within the Continental Division geographic area less than 25% of the time.


    • Bachelors Degree in healthcare management, Nursing, or Business required
    • Medical Coding certificate preferred

    Provides guidance to and actively participates with facility staff to identify, implement or enhance Denial reduction and NCD/LCD knowledge in collaboration with the Continental Division Denial Director and programs consistent with HCA and facility strategy



    Collaborate with payer escalations to identify resolutions for policies or procedures impacting denials.



    Assesses business office, revenue cycle and/or clinical opportunities that link with denial reduction, focusing on patterns of new denials and analysis of write-off opportunities.



    Disseminates information accurately and timely with multiple audiences



    Identifies process improvement opportunities; develops, implements, monitors, and revises action plans.



    Identifies and shares best-demonstrated practices; stays abreast of current practice standards


    Assist with developing, revising, and implementing HCA denial reduction or government compliance processes.



    Performs quality improvement activities to ensure data integrity relative to denial reduction activities, governmental compliance, and opportunities identified through the DMAT process.



    Fosters communication and facilitates collaboration between the facility Case Management, PAD, CFO, and other departments within HCA.



    Facilitates ongoing education within the division for identified areas and serves as a subject matter expert.



    Data analysis related to Denial Management, payer trends, etc.



    Assesses learning needs relating to denial reduction and government compliance and implements appropriate educational activities to expand the knowledge base.


    As part of HCA Healthcare, we at HealthONE® serve the metro Denver area as the largest healthcare system, with more than 11,000 employees. Our hospitals – The Medical Center of Aurora, North Suburban Medical Center, Presbyterian/St. Luke’s Medical Center, Rocky Mountain Hospital for Children, Rose Medical Center, Sky Ridge Medical Center, Swedish Medical Center and Spalding Rehabilitation Hospital work together to provide a higher level of care. In addition, our system includes eight hospital freestanding emergency departments and numerous ambulatory surgery centers, eight CareNow urgent care centers and occupational medicine clinics, physician practices, medical imaging centers and AirLife Denver, which provides critical care air and ground transportation serving Colorado and surrounding states.


    "Good people beget good people."- Dr. Thomas Frist, Sr.
    HCA Healthcare Co-Founder

    Unlock your potential with a leading healthcare provider dedicated to its patients, colleagues and communities. Help guide our team as a Denial Prevention Manager and help us improve more lives in more ways.

    We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

  • 29 Days Ago

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Cleaner
  • Aware Manager
  • Denver, CO PART_TIME,FULL_TIME
  • Cleaner We are looking for a Cleaner to take care of our facilities and carry out cleaning and maintenance duties. The goal is to keep our building in a clean and orderly condition. Responsibilities C...
  • 3 Days Ago

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PROJECT MANAGER, YOUTH VIOLENCE PREVENTION
  • Denver Public Schools
  • Denver, CO FULL_TIME
  • PROJECT MANAGER, YOUTH VIOLENCE PREVENTION (JOB ID: 63985) PROJECT MANAGER, YOUTH VIOLENCE PREVENTION EMILY GRIFFITH CAMPUS Northeast: Northwest: Southeast: Southwest Traditional 235 work days This is...
  • 13 Days Ago

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Health Care Fraud Specialist
  • US Defense Health Agency
  • Aurora, CO FULL_TIME
  • Duties Coordinating fraud and abuse investigative activities. Executing anti-fraud/abuse policies and procedures. Monitoring and providing oversight of contractor program integrity activities. Develop...
  • 1 Month Ago

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Unarmed Security Officer - Denver, CO
  • THE LOSS PREVENTION GROUP, INC
  • Denver, CO FULL_TIME
  • We are looking for unarmed security officers in Denver!! Do you have a passion for service and helping others? Do you have an eye for great attention to detail? Can you show leadership in critical sit...
  • 21 Days Ago

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Unarmed Security Officers - Denver and Aurora Locations
  • THE LOSS PREVENTION GROUP, INC
  • Denver, CO FULL_TIME
  • Metro One is looking for unarmed security officers for Denver and Aurora locations!! Do you have a passion for service and helping others? Do you have an eye for great attention to detail? Can you sho...
  • Just Posted

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0 Fraud Prevention Manager jobs found in Aurora, CO area

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Project Safety Coordinator
  • Kraemer North America
  • Denver, CO
  • Kraemer North America (Kraemer) is currently looking for a Project Safety Coordinator to join our team in our Mountain W...
  • 4/29/2024 12:00:00 AM

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Loss Prevention Investigator
  • The Michael's Companies
  • Denver, CO
  • Loss Prevention Investigator page is loaded Loss Prevention Investigator Apply locations Irving-Irving Corporate Office-...
  • 4/28/2024 12:00:00 AM

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Store Loss Prevention Investigator
  • Lvmh
  • Westminster, CO
  • PosteStore Loss Prevention InvestigatorProfilJob ID: 246593Store Name/Number: CO-Orchard Town Center (1344)Address: 1458...
  • 4/28/2024 12:00:00 AM

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Guest Service Representative
  • White Lodging Services Corp.
  • Denver, CO
  • **Guest Service Representative** **Job Description** Summary: The GSR II completes guest registration, room assignments,...
  • 4/28/2024 12:00:00 AM

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Moving Operations Manager
  • Alchemy Global Talent Solutions
  • Denver, CO
  • Alchemy is working with a reputable moving company that is looking for a Moving Operations Manager for their location in...
  • 4/28/2024 12:00:00 AM

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Supervisor - Customer Advocacy (Remote Work Assignment Available)
  • Frontier Airlines
  • Denver, CO
  • Why Work for Frontier Airlines? At Frontier, we believe the skies should be for everyone. We deliver on this promise thr...
  • 4/28/2024 12:00:00 AM

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Barback - 54thirty
  • White Lodging Services Corp.
  • Denver, CO
  • **Barback - 54thirty** **Job Description** Summary: The Barback ensures that the bar area is clean. The Barback maintain...
  • 4/27/2024 12:00:00 AM

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General Manager
  • Bass Pro Shops
  • Lone Tree, CO
  • Pay Range: $130,000.00 - $180,000.00 POSITION SUMMARY: The General Manager is responsible for the day-to-day management ...
  • 4/26/2024 12:00:00 AM

Aurora (/əˈroʊrə/, /əˈrɔːrə/) is a Home Rule Municipality in the U.S. state of Colorado, spanning Arapahoe and Adams counties, with the extreme southeastern portion of the city extending into Douglas County. Aurora is one of the principal cities of the Denver-Aurora-Lakewood, CO Metropolitan Statistical Area (Metro Denver). The city's population was 325,078 in the 2010 census, which made it the third most populous city in the state of Colorado and the 54th most populous city in the United States. The Denver-Aurora-Lakewood, CO Metropolitan Statistical Area had an estimated population of 2,645,...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Fraud Prevention Manager jobs
$98,994 to $131,765
Aurora, Colorado area prices
were up 0.4% from a year ago

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