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Denials Manager Jobs in Florida (NOW HIRING)

Phsorg

$16.66 - $26.70/hr

Patient Accounting Denials Specialist I Summary: Build your Career. Make a Difference. Presbyterian ... Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced ...

Glycare

Denials and Appeals Specialist

Jacksonville, FL · On-site

$16.25 - $21.50/hr

Denials and Appeals Specialist Accounts Receivable | Claims Follow-Up | Denial Management GlyCare is seeking an experienced Denials and Appeals Specialist to join our growing billing team in ...

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Denials Manager information

What is the difference between Denials Manager vs Claims Supervisor?

AspectDenials ManagerClaims Supervisor
CredentialsTypically requires healthcare administration, billing, or coding certificationsOften requires similar certifications, with additional supervisory or management training
Work EnvironmentManages denial appeals, reviews claim rejections, collaborates with billing and coding teamsOversees claims processing, supervises claims staff, ensures compliance with policies
Industry UsageCommon in healthcare, insurance, and hospital settingsCommon in healthcare organizations, insurance companies, and billing departments

While both roles focus on claims processing, the Denials Manager specializes in managing claim denials and appeals, whereas the Claims Supervisor oversees the entire claims process and staff. Both positions require healthcare billing knowledge and certification, but their primary responsibilities differ in scope and focus.

What are some common challenges faced by denials managers, and how can they effectively address them?

Denials Managers often encounter challenges such as identifying root causes of claim denials, staying updated with changing payer policies, and coordinating between billing, coding, and clinical teams. To address these challenges, Denials Managers typically implement robust tracking systems, conduct regular staff training, and foster open communication across departments. Proactively analyzing denial trends and collaborating on process improvements are key strategies to reduce future denials and enhance overall revenue cycle performance.

What is a denials manager?

A Denials Manager is a healthcare professional responsible for overseeing and managing the process of claim denials from insurance companies. Their primary role is to identify the causes of denied claims, implement strategies to reduce future denials, and ensure timely resolution and appeal of denied claims to maximize revenue for healthcare organizations. Denials Managers often collaborate with billing, coding, and clinical staff to ensure compliance with payer requirements and improve the overall reimbursement process. They play a crucial role in maintaining the financial health of medical practices or hospitals by minimizing lost revenue due to claim denials.

What are the key skills and qualifications needed to thrive as a denials manager?

To thrive as a Denials Manager, you need a deep understanding of medical billing, coding, insurance processes, and healthcare regulations, usually supported by a degree in healthcare administration or a related field. Familiarity with revenue cycle management systems, electronic health records (EHRs), and data analytics tools is essential, and certification like Certified Revenue Cycle Representative (CRCR) can be advantageous. Strong analytical thinking, problem-solving, and communication skills help in effectively leading teams and negotiating appeals with payers. These skills are critical for minimizing revenue loss, ensuring compliance, and optimizing reimbursement processes within healthcare organizations.
What cities in Florida are hiring for Denials Manager jobs? Cities in Florida with the most Denials Manager job openings:
Denials Manager jobs near you

Supervisor, Training

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 28 days ago

Job description

HBiz is a leading provider of revenue cycle management solutions, specializing in reducing denial rates and enhancing the financial outcomes for healthcare providers. We are seeking a motivated and experienced Training Supervisor to oversee our training department, specifically focusing on revenue cycle denials management. This role is key to developing and implementing effective training strategies that ensure our staff is well-equipped to handle the challenges of revenue cycle management efficiently.


Key Responsibilities:

  • Lead the development, execution, and evaluation of training programs tailored to revenue cycle management and denials prevention.
  • Supervise a team of trainers, providing guidance, feedback, and support to enhance training delivery and effectiveness.
  • Collaborate with senior management to identify training needs and ensure alignment with business goals and strategies.
  • Design and update training curricula and materials, incorporating the latest industry trends and regulatory requirements.
  • Monitor training outcomes and metrics to assess program success and identify areas for improvement.
  • Facilitate advanced training sessions and workshops, including leadership training for revenue cycle managers and executives.
  • Ensure compliance with all applicable laws, regulations, and company policies throughout training activities.
  • Manage the training budget, optimize resources, and negotiate contracts with external training providers as needed.
  • Promote a culture of continuous learning and professional development within the organization.


Required Qualifications:

  • Bachelor’s degree in Business Administration, Healthcare Administration, Education, or related field; Master’s degree preferred.
  • Minimum of five years of experience in training and development, with at least three years in a supervisory role within the healthcare or revenue cycle industry.
  • Strong background in revenue cycle processes, particularly in denials management.
  • Proven leadership skills and the ability to mentor and motivate a team of trainers.
  • Excellent verbal and written communication skills, with a demonstrated ability to develop engaging and effective training materials.
  • Proficiency in utilizing Learning Management Systems (LMS) and other training technologies.


Desired Skills:

  • Certification in training and development, such as ATD Master Trainer Certification.
  • Experience implementing innovative training solutions such as e-learning and virtual training.
  • Strong analytical skills to evaluate training effectiveness and ROI.
  • Exceptional organizational and project management skills.

What We Offer:

  • A competitive salary and comprehensive benefits package including health, dental, and vision insurance, 401(k) with company match, and ample paid time off.
  • Opportunities for ongoing professional development and career advancement.
  • A dynamic work environment where your contributions are truly valued.

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