Department

Patient Financial Services
Job Summary

This leader has accountability and oversight, and supervises the daily activities of the Denials, Appeals, and Recovery department. In this role, the leader sets the tone and models positive leadership behavior, while ensuring individual and teamwork tasks, projects, and responsibilities are completed successfully in support of departmental, organizational goals.

Required Qualifications

- Bachelor's degree required. Relevant work experience can substitute on a year-for-year basis for the required degree.
- Require a minimum of ten (10) years of managed care, appeals/denials and/or reimbursement schedules experience, in which, five (5) years are in written appeals.
- Required Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification by the American Health Information Management Association (AHIMA).

Preferred Qualifications

- Prefer knowledge of Medicare National Coverage Determinations (NCD) and Local Coverage Determination (LCD) protocols for medical necessity/Advanced Beneficiary Notice (ABN).
- Prefer demonstrated leadership skills and understanding of group processes, teamwork, and cost center based management.
- Prefer demonstrated knowledge of International Classification Determination Tenth Revision (ICD-10), Current Procedural Terminology (CPT), Diagnosis-Related Groups (DRG), Healthcare Common Procedural Coding System (HCPCS), and Revenue codes.
- Prefer knowledge of insurance rules and regulations including Medicare, Medicaid, Managed Care and Commercial Insurance.
- Prefer familiarity with Florida statutes as they pertain to managed care operations.
- Prefer familiarity with managed care contracts and policies/procedures as well as overall operations.
- Prefer demonstrated ability in establishing and maintaining effective working relationships.
- Prefer demonstrated ability to analyze problems and consistently follow through to solution.
- Prefer demonstrated ability to take initiative and exercise independent judgment, decision-making, and problem solving expertise.
- Prefer demonstrated effective oral and written communication skills at all levels.

Onsite position. Monday through Friday.

The benefits of being the best:

Our commitment to becoming the best community hospital and health care system means providing the best possible benefits to our people. Some highlights:

Total Rewards Package

• Paid Time Off (start earning PTO on day one of employment)
• Tuition Reimbursement
• Discounted Medical, Prescription, Dental, Vision Benefit Plans for Full & Part-Time Employees
• Flexible Spending Accounts (Health Care and Dependent Care) - Pre-Tax Dollars
• Life Insurance
• Competitive rates
• Bonuses offered
• Disability Insurance
• Retirement Savings Plan: 403b
• Sarasota Campus for now - Discounted Child Care & Before and After School Program and Summer Camp!
• Bereavement Leave
• Free Parking
• On Campus Dining w/ a 10% discount
• Credit Union w/ teller machines on campus
• Direct Deposit
• Free Wellness Screening
• Free confidential counseling services
• Employee Discount Programs
• Recognition Programs
• Referral Programs
• Tremendous growth opportunities for hard workers!