Denials Specialist Sr

Job Summary

Under the direction of the Manager, Denials Team, responsible for reviewing denied claims and carrying out the appeals submission process at Tampa General Hospital. Works to maintain third-party payer relationships, including responding to inquiries, complaints, and other correspondence, and possibly setting up arbitration between parties. Responsible for denial avoidance review as well as denial review. Knowledgeable of state/federal law that relate to contract and to the appeals process. Maintains and monitors integrity of the claim development and submission process. Responsible for performing job duties in accordance with mission, vision and values of Tampa General Hospital.

Qualifications

• High school graduate or GED.
• A minimum of five (5) years of Hospital experience in billing and collecting Medicare/Medicaid; working knowledge of Federal, State and County guidelines as it relates to billing; and knowledge of electronic billing systems.
• BA degree in Finance, Accounting, Healthcare Administration or Healthcare Analytics preferred.