Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
All the benefits and perks you need for you and your family:
Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
900 HOPE WAY
City:
ALTAMONTE SPRINGS
State:
Florida
Postal Code:
32714
Job Description:
Directs audits and manages denials to minimize errors, rejections, and avoidable denials. Ensures follow-up and denial management activities align with standards, policies, guidelines, training, and practices. Analyzes data to identify root causes of denials and implements process improvements to prevent repeated errors. Collaborates with Revenue Cycle stakeholders to facilitate data sharing and maximize claims reimbursement. Monitors and reviews team performance for timeliness, productivity, and quality standards. Sets annual departmental goals and provides direction based on organizational standards. Resolves problems, including HR issues, and allocates resources effectively. Staffs, trains, and mentors team members to ensure high performance. Maintains and updates procedures to align with best practices and regulatory requirements. Approves staffing realignment and performance appraisals based on supervisors' and director's recommendations. Ensures timely, accurate, and comprehensive documentation of all claim activities. Serves as a liaison between multiple Revenue Cycle Departments, including Consumer Access, Patient Financial Services, Managed Care, and Revenue Integrity. Other duties as assigned.
Knowledge, Skills, and Abilities:• Analyze, track, trend and escalate issues as needed in order to facilitate optimal revenue recovery [Required]
• Ingenuity and judgment are required to review facts, plan work, estimate costs, interpret results, draw conclusions, and take or recommend action [Required]
• Self-starter with the ability to work under limited day-to-day oversight [Required]
• Strong supervisor/management skills, providing clear performance expectations as well as evaluating/resolving performance problems. [Required]
• Time management proficient [Required]
• Critical thinking and analytical skills [Required]
• Proactive [Required]
• Results driven [Required]
• Strong attention to detail [Required]
• Ability to work in a project-oriented environment with people of various background [Required]
• Ability to work in a fast-paced dynamic environment and meet deadlines [Required]
• Comfortable providing group presentations [Required]
• Strong understanding of payer reimbursement and denial functions related to all payers including but not limited to Managed Care/Commercial, Managed Medicare, Medicaid, Medicaid HMO products and Government (i.e. VA and Tricare), [Required]
• Understanding of the application and interpretation of contract language and rates. [Required]
• Uses discretion when discussing personnel/patient related issues that are confidential in nature [Required]
• Effective oral and written communication skills, with the ability to articulate complex information to all levels of colleagues [Required]
• Proficiency in Microsoft Suite applications, specifically Excel, Word, and PowerPoint applications, as well as Outlook [Required]
• Strong organizational skills [Required]
• Strong keyboard and 10 key skills [Required]
• Proficiency with medical billing and remittance forms and processes, including 835 and 837 files, and UB04 and CMS-1500 (HCFA) forms [Preferred]
• Understanding of PFS registration and billing processes [Preferred]
Education:• Bachelor's [Required]
• Master's [Preferred]
Field of Study:• (in Business, Healthcare or Health Services Administration, Health Information Management, Communications, Finance, Accounting, Public Administration, Human Resources, Management, or Marketing), OR Minimum of five years related work experience in a hospital-based revenue cycle department or related area (registration, finance, collections, customer service, medical office/physician, or contract management).
• (in Health Management, Business Administration, Finance, or other related area.)
Work Experience:• 3+ hospital denial management experience in a large, integrated healthcare delivery system [Required]
• 3+ supervisory/managerial position in a similar-sized healthcare organization [Required]
Additional Information:• N/A
Licenses and Certifications:• N/A
Physical Requirements: (Please click the link below to view work requirements)Physical Requirements -
https://tinyurl.com/23km2677Pay Range:
$83,699.48 - $155,693.55
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
