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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 ...

TEKsystems

Denials Specialist

Jacksonville, FL · Remote

$26/hr

Requirements: • 2+ years of healthcare denial management, medical billing, accounts receivable, or revenue cycle experience • Experience working commercial insurance denials and appeals • Epic ...

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Denials Manager information

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 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 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 popular job titles related to Denials Manager jobs in Florida?

For Denials Manager jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Denials Manager jobs in Florida look for?

The top searched job categories for Denials Manager jobs in Florida are:

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, Revenue Cycle Clinical Coder Denials | Enterprise Denials

UF Health

Gainesville, FL • Remote

Full-time

Re-posted 9 hours ago

Job description

Overview

Lead a remote team focused on coding denials, reimbursement optimization, and operational performance.

???? Work Style: Remote
???? Location Requirement: Must reside in an authorized state (FL, GA, PA, NC, SC, TN, or TX)
???? FTE: Full-Time (1.0 FTE)

Oversees the accuracy and compliance of billing processes to safeguard organizational revenue. Coordinates audits, monitors revenue cycle activities, and collaborates with various teams to ensure precise documentation and coding. Trains staff on revenue integrity policies, analyzes financial data for strategic insights, and implements improvements to optimize revenue capture. Ensures adherence to legal and organizational guidelines is a key aspect of this position.


Responsibilities

Key Responsibilities

  • Oversees billing accuracy and compliance to safeguard revenue.
  • Coordinates audits and monitors revenue cycle activities.
  • Collaborates with teams to ensure precise documentation and coding.
  • Trains staff on revenue integrity policies.
  • Analyzes financial data for strategic insights.
  • Implements improvements to optimize revenue capture.
  • Ensures adherence to legal and organizational guidelines.
 

Qualifications
Required Education

  • High School Diploma or GED

Minimum Qualifications

  • 3+ years of experience in revenue integrity, revenue cycle, or healthcare compliance.
  • Knowledge of billing accuracy, reimbursement processes, and regulatory requirements.
  • Experience conducting audits and training staff on revenue integrity policies and procedures.
  • Strong analytical skills with experience reviewing financial and operational data.
  • Ability to identify, recommend, and implement revenue optimization strategies.
 
Preferred Education

  • Associate’s degree in a healthcare or business-related field

Preferred Qualifications

  • One of the following certifications: CPC, COC, RHIT, RHIA, or CCS.
  • Three (3) to five (5) years of healthcare revenue cycle experience.
  • Minimum of three (3) years of experience in medical coding, insurance, or denial management.
  • Minimum of three (3) years of supervisory or management experience leading coding or revenue cycle teams.
  • Experience supervising 1–5 employees.

Preferred Skills

  • Demonstrated knowledge of hospital billing, reimbursement, denials and appeals, third-party payer contracts, insurance protocols, and revenue cycle workflows.
  • Knowledge of federal and state healthcare regulations related to billing, coding, and reimbursement.
  • Ability to identify problems, develop solutions, and implement process improvements.
  • Strong time management, organizational, and multitasking skills with the ability to meet deadlines in a fast-paced environment.
  • Proven leadership, conflict resolution, and customer service skills.
  • Excellent written, verbal, and interpersonal communication skills.
  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint, and other healthcare information systems.

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