MGR DENIALS RECOVERY

H. Lee Moffitt Cancer Center

Tampa, FL

ID: 7100929 (Ref.No. hlj_37643)
Posted: May 27, 2022
Application Deadline: Open Until Filled

Job Description

Management of Denial Recovery

Position Highlights:

 

Reporting to the Director of PFS, the Manager of Denial Recovery plays a leadership role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation through the recovery of any unpaid revenue. This position is accountable for the review, analysis and trending of denials; working with the appropriate individuals in the service departments, Clinics, Financial Clearance, Scheduling, IT, etc., on gap analysis and process improvement to prevent denials; working with Managed Care Contracting on contract-related issues; Billing and Collections on billing requirements and administrative appeals, Revenue Integrity on issues related to CDM or edits, HIM on issues related to coding as well as leads monthly Denial Management Steering Committee meetings .

 Qualifications include:

 

·        Bachelor's Degree in Healthcare or related field.

·        Registered Nurse ("RN") required.

·        Seven years recent experience in denial management, healthcare billing, revenue cycle or related finance experience required.

·        Three years recent supervisory experience.

·        Must have revenue code and CPT coding knowledge.

·        Previous experience and familiarity with CMS regulations, billing compliance, Medicare, Medicaid and other third party payer reimbursement methodologies.

·        Experienced in medical record auditing, training and interpreting analytics.

·        Excellent interpersonal and communication skills to positively interact with a variety of hospital personnel, including physicians and executive level management staff.

·        Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, Excel and Access.

·        Proficient skills to collect, organize and analyze data, produce actionable reports and recommend improvements and solutions.

·         Possess effective oral and written skills. Must possess the ability to present information in large groups routinely.

·      Ability to interpret and implement regulatory standards.

 



Mission To create a Moffitt culture of diversity and inclusion as we strive to contribute to the prevention and cure of cancer. Vision Moffitt Cancer Center is recognized as the model wherein the diversity of our employees and communities is valued and supported as essential components to contributing to the prevention and cure of cancer. The cancer center is an equal opportunity employer. It is the policy of the cancer center to prohibit unlawful discrimination and harassment of any type and to afford equal employment opportunities to workforce members and applicants, regardless of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, marital status, disability, genetic information, veteran’s status or any other characteristic protected by federal, state or local law.