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.

• 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]

• Bachelor's Degree [Required]
• Master’s Degree [Preferred]

• Bachelor’s Degree in Business, Healthcare or Health Services Administration, Health Information Management, Communications, Finance, Accounting, Public Administration, Human Resources, Management, or Marketing
• Master’s Degree in Health Management, Business Administration, Finance, or other related area

• 3+ years of experience in hospital denial management experience in a large, integrated healthcare delivery system [Required]
• 3+ years of experience in a supervisory/managerial position in a similar-sized healthcare organization [Required]
• Understanding of PFS registration and billing processes [Preferred]

• An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:
• Bachelor’s degree OR 4+ years of related work experience in a hospital-based revenue cycle department or related area (registration, finance, collections, customer service, medical office/physician, or contract management)

• Certified Healthcare Financial Professional (CHFP) [Preferred]
• Certified Patient Access Management (CPAM) [Preferred]
• Certified Revenue Cycle Rep (CRCR) [Preferred]
• Fellow of the Healthcare Financial Management Association (FHFMA) [Preferred]

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.