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DENIALS RECOVERY LEAD

H. Lee Moffitt Cancer Center

Location: 33612
Type: Full-Time, Non-Remote
Posted on: July 28, 2021
This job is no longer available from the source.
DENIALS RECOVERY LEAD Business & Information Technology Hours: M-F: 7a - 3:30p Day Shift - Full Time Paygrade/Wages/Salary Info: NE N30 - 29.0000 - 36.4500
Position Highlights: Responsible for assisting the administration and coordination of the denials review and appeals management processes for managed care payers. Assisting with the review, training, management and coordination of recovery / overpayment audits received from entities The Ideal Candidate: The Ideal Candidate will have experience in appeals/denials management in a physician or hospital environment. The#candidate will have experience in oncology nursing, utilization review, quality management, and/or recent case management. The candidate will have knowledge of financial data analysis, Medicare and Medicaid regulations, third party reimbursement and charging and coding guidelines Responsibilities: CoAssisting with ensuring the denials are appealed timely and efficiently, trends are identified and communicated, and denials are reduced Assists with ensuring collection and recording in the appropriate systems of all denial related information for effective root cause analysis Assists as a liaison for internal and external customers; promotes a positive and professional image of department for all customers Assists with maintaining and monitoring the guidelines set forth in the Department and Hospitals# policies and procedures as they relate to the department#s conduct and responsibilities Recruits, hires and supervises staff; assesses and conducts staff evaluations and annual reviews, coaches, and administers disciplinary action. Credentials and Experience: Bachelor#s degree in Healthcare, Business, Finance or related field Minimum of five (5) years healthcare experience *****in lieu of a Bachelor#s degree, you must have an Associate#s degree plus an additional two (2) years (totaling 7 years) of healthcare experience preferably in Nursing Two (2) years of appeals/denial management experience in a physician or hospital environment RN Certification