DENIALS RECOVERY SPECIALIST

H. Lee Moffitt Cancer Center

Tampa, FL

Job posting number: #7100218 (Ref:hlj_37551)

Posted: May 17, 2022

Application Deadline: Open Until Filled

Job Description

Denials Recovery Specialist

 

REMOTE position. - in the following states: AL, AZ, AK, GA, FL, IA, IN, IO, KS, LA, MS, MO, MT, NC, OH, OK, SC, SD, TN, TX, UT, VA, WY

 

Position Highlights:

Responsible for the coordination and management of timely insurance claim follow-up including identifying, monitoring, appealing, and resolving denied claims.  Perform detailed analysis on denied claims with a focus on maximizing revenue.

 

The Ideal Candidate:

  • In depth knowledge of Medicare and Medicaid regulations, third party reimbursement guidelines.
  • Computer literate, knowledge of financial data analysis, intermediate Excel skills.
  • Preferred – Physician claims experience in a multi-specialty environment, preferably with oncology and/or surgical experience.

  

Responsibilities:

 

  • Follow-up electronically and/or telephonically with payors for claim and appeal status.    
  • Make a preliminary determination whether denial can be overturned and if initial or secondary appeals should be submitted.
  • Research and prepare responses for payor requests for additional information and documentation.
  • Review of non-clinical denials including identification of root cause.
  • Resolve non-clinical denials which include researching and reviewing payor guidelines, writing and submitting appeals with supporting documentation if required.  
  • Other duties as assigned.

 

Credentials and Qualifications:

  • Associate degree required.
  • A minimum of three (3) years’ experience working with medical claims in a hospital, physician, payor or third-party medical billing service setting with collection experience.

* "in lieu of" Associate's, a H.S. Diploma with two (2) years of additional related claims/collection experience maybe considered.

**In lieu of the three (3) years medical experience, five (5) years collection experience in a non-medical setting will be considered.



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.


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More Info

Job posting number:#7100218 (Ref:hlj_37551)
Application Deadline:Open Until Filled
Employer Location:H. Lee Moffitt Cancer Center
Tampa,Florida
United States
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