DENIALS RECOVERY LEAD

H. Lee Moffitt Cancer Center

Tampa, FL

Job posting number: #7107673 (Ref:hlj_38959)

Posted: August 10, 2022

Application Deadline: Open Until Filled

Job Description

Denials Recovery Lead

 

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:

Acts in a leadership support role to the Denial Team Members. Responsible for assisting the administration and coordination of the denials review and appeals management processes for managed care payers. Assisting with the review, training, management and coordination of recovery / overpayment audits received from entities.  

Responsibilities:

  • Team member evaluation of Appeal Process; Assisting with ensuring the denials are appealed timely and efficiently
  • Team member support; Assisting with ensuring denial recover and recording in the appropriate systems of all denial related information for effective root cause analysis
  • Leadership Support
  • New hire evaluations
  • Training
  • Denial Document Development
  • Departmental Liaison

Credentials and Qualifications:

  • RN Licensure
  • Bachelor’s degree required.
  • A minimum of five (5) years’ experience of directly related healthcare experience that includes two (2) years of appeals/denials management in a physician or hospital environment.

 

* "in lieu of" Bachelor's degree an Associates degree plus an additional two (2) years of directly related healthcare experience, preferably in nursing for a total of seven (7) years may be considered.

 

Preferred:

  • Experience in oncology nursing, utilization review, quality management, and/or recent case management.
  • Computer literate, knowledge of financial data analysis, Medicare and Medicaid regulations, third party reimbursement, & charging and coding guidelines.


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:#7107673 (Ref:hlj_38959)
Application Deadline:Open Until Filled
Employer Location:H. Lee Moffitt Cancer Center
Tampa,Florida
United States
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