Offer summary

Qualifications:

Associate degree required or a H.S. Diploma with additional related experience., Minimum of three years' experience in medical claims or billing., In-depth knowledge of Medicare and Medicaid regulations and reimbursement guidelines., Intermediate Excel skills and computer literacy. .

Key responsabilities:

Coordinate and manage timely follow-up on insurance claims.

Perform detailed analysis on denied claims to maximize revenue.

Research and prepare responses for payor requests for additional information.

Resolve non-clinical denials by reviewing payor guidelines and submitting appeals.

At Moffitt Cancer Center, we come face-to-face with cancer every day, but we also see courage. And it inspires us to be the safest and best place for cancer care – to bring greater hope to every patient we serve. It’s why we’ve been continually named One of the Top Places to Work in the Tampa Bay Area. As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Moffitt is the top cancer hospital in Florida according to U.S. News & World Report and has been nationally ranked since 1999. Because working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. Join a dedicated, diverse and inclusive team of over 7,000 to be a part of the Courageous future we envision.

Job description

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 (total of 5) may be considered.

Required profile