Manager Denials Management

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:

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Job Description:

• Manages daily operations of the denials management team
• Supervises, coaches, and develops denial management specialists
• Monitors team performance against established metrics and productivity standards
• Reviews and approves appeals for accuracy and quality
• Analyzes denial trends and develops remediation strategies
• Coordinates with payers on complex denial issues and escalations
• Ensures compliance with all regulatory requirements and policies
• Prepares and presents reports on denial performance
• Participates in hiring, training, and performance management processes
• Identifies opportunities for process improvement and implements solutions
• Collaborates with revenue cycle leadership on strategic initiatives
• Performs other duties as assigned

Knowledge, Skills, and Abilities:

• Comprehensive understanding of revenue cycle processes including charge capture, billing, and reimbursement [Required]

• Knowledge of CPT, HCPCS, ICD coding systems, and billing regulations for government and commercial payers [Required]

Knowledge of payer policies, denial processes, and appeal strategies [Required]

• Demonstrated leadership skills with ability to supervise and develop staff [Required]

• Strong analytical skills with ability to interpret data and identify trends [Required]

• Excellent written and verbal communication skills [Required]

• Proficiency in Microsoft Suite applications and healthcare information systems [Required]

• Ability to build collaborative relationships across departments [Required]

• Proficiency with Epic EHR system [Preferred]

• Experience with process improvement methodologies [Preferred]

• Experience with denial management technology platforms [Preferred]

Education:

• Bachelors degree [Required]

• Masters degree [Preferred]

Field of Study:

• In Business, Healthcare, Health Services Administration, Health Information Management, Communications, Finance, Accounting, Public Administration, Human Resources, Management, or Marketing

Work Experience:

• 3+ years Revenue Cycle experience [Required]

• 3+ years leadership experience [Required]

Additional Information:

• An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:

• Bachelors degree AND 3+ years of relevant work experience [Required] OR

• Associates degree AND 5+ years of relevant work experience [Required] OR

• 7+ years of relevant work experience [Required]

Licenses and Certifications:

• Healthcare Financial Management Association (HFMA) [Preferred]

• Certified Revenue Cycle Rep (CRCR) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.