Current jobs related to Revenue Cycle Denials Manager - Tampa, Florida - SNI Companies
-
Revenue Cycle Specialist
1 month ago
Tampa, Florida, United States Orthopaedic Solutions Management Full timeJob SummaryWe are seeking a highly skilled Revenue Cycle Specialist to join our team at Orthopaedic Solutions Management. As a key member of our revenue cycle team, you will play a critical role in ensuring timely collection of accounts receivable and maximizing reimbursement for our ancillary billing.Key ResponsibilitiesResearch and resolve claims denials...
-
Revenue Cycle Specialist
2 weeks ago
Tampa, Florida, United States Orthopaedic Solutions Management Full timeJob SummaryWe are seeking a highly skilled Revenue Cycle Specialist to join our team at Orthopaedic Solutions Management. As a key member of our revenue cycle team, you will be responsible for managing the flow of medical claims and ensuring timely payment from insurance carriers.Key Responsibilities:Manage and resolve denied claims in a timely and efficient...
-
Finance and Revenue Cycle Program Specialist
5 days ago
Tampa, Florida, United States Tampa General Hospital Full timeThis position reports directly to the Revenue Cycle Manager at Tampa General Hospital in a role that has several distinct functions. The Finance and Revenue Cycle Program Specialist will drive strategic process improvement, manage complex projects, and solve difficult problems. The Finance and Revenue Cycle Program Specialist will demonstrate project...
-
Tampa, Florida, United States Sherloq Solutions Full timeAbout Sherloq SolutionsSherloq Solutions is a leading provider of revenue cycle services, dedicated to delivering exceptional results in the healthcare industry. Our team is passionate about helping healthcare providers and payers maximize their revenue and improve patient outcomes.Job SummaryWe are seeking a highly skilled Medical Billing Specialist,...
-
Finance and Revenue Cycle Specialist
2 weeks ago
Tampa, Florida, United States Tampa General Hospital Full timeJob SummaryThis role reports directly to the Revenue Cycle Manager at Tampa General Hospital, driving strategic process improvement, managing complex projects, and solving difficult problems.Key ResponsibilitiesDrive strategic process improvement and manage complex projectsSolve difficult problems and demonstrate project management skillsManage Payer...
-
Finance and Revenue Cycle Program Specialist
1 month ago
Tampa, Florida, United States Tampa General Hospital Full timeJob SummaryThis role reports directly to the Revenue Cycle Manager at Tampa General Hospital, overseeing strategic process improvement, managing complex projects, and solving difficult problems. The Finance and Revenue Cycle Program Specialist will drive project management skills and possess relevant finance and revenue cycle knowledge to ensure project...
-
Denial Specialist
1 month ago
Tampa, Florida, United States Accounting Now Full timeJob Title: Denial SpecialistAt Accounting Now, we are seeking a highly skilled Denial Specialist to join our team. As a key member of our revenue cycle team, you will play a critical role in ensuring timely and accurate reimbursement for our clients.Key Responsibilities:Denial Management: Conduct comprehensive reviews of insurance denials and work with...
-
Tampa, Florida, United States Sherloq Solutions Full timeJob DescriptionSherloq Revenue Solutions is seeking a Medical Billing Specialist, Insurance Revenue Cycle to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims through verbal or online inquiries to health insurance payers.Key Responsibilities:Resolve healthcare claims through verbal or online...
-
Tampa, Florida, United States Sherloq Solutions Full timeJob DescriptionSherloq Revenue Solutions is seeking a highly skilled Medical Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims through verbal or online inquiries to health insurance payers.Key ResponsibilitiesEffectively navigate and utilize various healthcare provider...
-
Clinical Denials Specialist
4 weeks ago
Tampa, Florida, United States Accounting Now Full timeJob Title: Clinical Denials SpecialistAt Accounting Now, we are seeking a highly skilled Clinical Denials Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for managing and appealing clinical denials to ensure accurate reimbursement for our clients.Key Responsibilities:Denial Management: Formulate strategies for...
-
Tampa, Florida, United States Sherloq Solutions Full timeWe are seeking a skilled Medical Billing Specialist to join our team at Sherloq Revenue Solutions. This full-time position is part of our Insurance Revenue Cycle department, where you will play a crucial role in resolving healthcare claims and ensuring accurate billing and reimbursement.Key Responsibilities:Resolve healthcare claims through verbal or online...
-
Clinical Denials Specialist
5 days ago
Tampa, Florida, United States SNI Companies Full timeJob Title: Clinical Denials SpecialistJob Summary:We are seeking a highly skilled Clinical Denials Specialist to join our team at SNI Companies. As a Clinical Denials Specialist, you will be responsible for conducting a comprehensive review of insurance denials and working with our Clinical Denials Nurses and Coding Denials Specialists to compile appropriate...
-
Revenue Cycle Specialist
2 weeks ago
Tampa, Florida, United States Orthopaedic Solutions Management Full timeJob SummaryAs a Revenue Cycle Specialist at Orthopaedic Solutions Management, you will play a vital role in ensuring timely collection of accounts receivable and monitoring account activity to maximize reimbursement for Ancillary billing.This position requires a strong understanding of medical claims billing and the ability to research and resolve claims...
-
Senior Director of Revenue Cycle Operations
1 month ago
Tampa, Florida, United States Tampa General Hospital Full timeJob OverviewThe Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning for Tampa General Hospital's Revenue Cycle department. This position ensures alignment with organizational goals and industry standards to drive profitability.Key ResponsibilitiesLead the oversight and management of the...
-
Director, Revenue Cycle Applications
1 month ago
Tampa, Florida, United States Vaco Full timeJob Title: Director, Revenue Cycle ApplicationsAt Vaco, we are seeking a highly skilled and experienced Director, Revenue Cycle Applications to join our team. As a key member of our organization, you will play a critical role in leading our revenue cycle applications efforts and driving business growth.Key Responsibilities:Proactively identify, assess, and...
-
Senior Director of Revenue Cycle Operations
1 month ago
Tampa, Florida, United States USF Health Full timeJob OverviewThe Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning for USF Health, aligning with organizational goals and industry standards to ensure profitability.Key ResponsibilitiesOversee and lead the Revenue Cycle department, including front desk operations, financial clearance,...
-
Senior Director of Revenue Cycle Operations
2 weeks ago
Tampa, Florida, United States Tampa General Hospital Full timeJob Overview:The Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning, aligning with organizational goals and best practice performance based on industry standards to ensure profitability.Key Responsibilities:Oversee and lead the activities and functions for the Revenue Cycle department,...
-
Senior Director of Revenue Cycle Operations
5 days ago
Tampa, Florida, United States Tampa General Hospital Full timeJob Overview:The Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning for Tampa General Hospital, aligning with organizational goals and industry standards to ensure profitability.Responsibilities:Oversee and lead the activities and functions of the Revenue Cycle department, including front...
-
Senior Director of Revenue Cycle Operations
1 week ago
Tampa, Florida, United States Tampa General Hospital Full timeJob Overview:The Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning, aligning with organizational goals and best practice performance based on industry standards to ensure profitability.Key Responsibilities:Oversee and lead the activities and functions for the Revenue Cycle department,...
-
Senior Director of Revenue Cycle Operations
2 weeks ago
Tampa, Florida, United States USF Health Full timeJob Overview:The Senior Director of Revenue Cycle Operations plays a pivotal role in shaping the strategic vision and long-term planning for USF Health, aligning with organizational goals and industry standards to ensure profitability.Key Responsibilities:Lead the oversight and leadership of the USFTGP Revenue Cycle department, encompassing front desk...
Revenue Cycle Denials Manager
2 months ago
**Job Title:** Clinical Denials Specialist
**Job Summary:**
We are seeking a highly skilled Clinical Denials Specialist to join our team at SNI Companies. As a Clinical Denials Specialist, you will be responsible for conducting a comprehensive review of insurance denials and working with our Clinical Denials Nurses and Coding Denials Specialists to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely manner.
Key Responsibilities:
- Denial Management: Formulate strategy for prioritizing cases and maintain aging within appropriate ranges with minimal direction or intervention from Leadership.
- Appeal Strategy: Reviews account history, remit, payer history, and state requirements to determine appropriate challenge and appeal strategy.
- Documentation and Communication: Gathers and fills out all special appeal or payer required forms, composes and submits all required documentation (including appropriate medical records to support medical necessity) for a reconsideration, appeal, or retro authorization to the insurance carrier via payer portal, fax, etc...
- Follow-up and Escalation: Follows up on submitted appeals through payer portal or phone calls to the payer, escalates issues in accordance with the department escalation policy.
- Critical Thinking and Problem-Solving: Uses critical thinking skills to resolve aged and problematic accounts, follows account to timely resolution to include appropriate financial adjustment.
- Collaboration and Communication: Interfaces with other departments to satisfactorily resolve issues related to appeals and initial denials, communicates with Pre-Cert team and/or medical office personnel to obtain pertinent information.
- Knowledge and Compliance: Maintains a thorough understanding of operations and business unit processes/workflows including, but not limited to authorizations and referral requirements, and in/out-of-network insurances, maintains payer portal access and utilizes said portals to assist in reviewing commercial medical policies or LCD and NCD (local and national coverage determination) rules.
- Trend Analysis and Reporting: Monitors for denial trends, works collaboratively with the revenue cycle teams to reduce revenue loss, helps identify issues from denials and appeals that might be avoided on future claims.
- Leadership Support: Assist department leadership with research, analysis and special projects, attends necessary payer meetings to escalate denials issues.
- Team Collaboration: Participate in huddle meetings and sharing the details of cases worked.
Qualifications:
- Experience: Two years' recent experience in healthcare revenue cycle or prior authorizations for inpatient/outpatient, hospital/physician.
- Skills: Experience in healthcare claims processing and proficiency with medical billing and remittance forms and processes, including 835 and 837 files, and UB04 and CMS-1500 (HCFA) forms, medical terminology.
