Revenue Cycle Clinical Director
Tampa, Florida
Employer: Moffitt Cancer Center
Industry: Financial Clearance Unit
Salary: Competitive
Job type: Part-Time
At Moffitt Cancer Center, we strive to be the leader in understanding the complexity of cancer and applying these insights to contribute to the prevention and cure of cancer. Our diverse team of over 9,000 are dedicated to serving our patients and creating a workspace where every individual is recognized and appreciated. For this reason, Moffitt has been recognized on the 2023 Forbes list of America's Best Large Employers and America's Best Employers for Women, Computerworld magazine's list of 100 Best Places to Work in Information Technology, DiversityInc Top Hospitals & Health Systems and continually named one of the Tampa Bay Time's Top Workplace. Additionally, Moffitt is proud to have earned the prestigious Magnet® designation in recognition of its nursing excellence.
Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center based in Florida, and the leading cancer hospital in both Florida and the Southeast. We are a top 10 nationally ranked cancer center by Newsweek and have been nationally ranked by U.S. News & World Report since 1999.
Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. Join our committed team and help shape the future we envision.
Summary
Position Highlights and Responsibilities:
Credentials and Experience:
Equal Employment Opportunity
Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status. We seek candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence.
Reasonable Accommodation
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
Moffitt endeavors to make moffitt.org/careers accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact one of the Human Resources receptionists by phone at 813-745-7899 or by email at HRReceptionists@moffitt.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.
If you'd like more information on your EEO rights under the law, please click here.
Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center based in Florida, and the leading cancer hospital in both Florida and the Southeast. We are a top 10 nationally ranked cancer center by Newsweek and have been nationally ranked by U.S. News & World Report since 1999.
Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. Join our committed team and help shape the future we envision.
Summary
Position Highlights and Responsibilities:
- The Revenue Cycle Dir peforms all aspects of the Peer to Peer Review Program, financial clearance and medical necessity check. Communicates with clinical counterparts at the payor and within the cancer center. Organizes and prioritizes encounters needing financial clearance due to pending Peer to Peer reviews to ensure timely patient care and secure reimbursement.
- This position is responsible for performing all peer to peer conversations for medically necessary services on behalf of ordering providers as well as providing feedback and education to physicians on upheld denials.
- Works directly with insurance companies (payors) using clinical expertise to obtain authorization and overturn pre-service denials. Reduces/minimizes the need to escalate cases to Moffitt physicians. Performs clinical review of medical records to determine if documentation is sufficient and contacts payors directly or reaches out to ordering physicians and/or clinical team to obtain additional information for the case prior to contacting payor to overturn the denial.
- Maintains a deep knowledge of payor classifications, rules and criteria for authorizationw and peer to peer process. Educates and advises providers and their clinical teams, Nursing team, payer strategies, pharmacy and Financial Clearance unite team.
Credentials and Experience:
- Bachelor's degree - field of study: Physicians Assistant (PA) or Advanced Practice Registered Nurse (APRN)
- Minimum of ten (10) years experience to include : a minimum of 3 years experience as a Physician Assistant (PA) or Advanced Practice Registered Nurse (APRN) and the remaining experience can be as a RN
Equal Employment Opportunity
Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status. We seek candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence.
Reasonable Accommodation
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
Moffitt endeavors to make moffitt.org/careers accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact one of the Human Resources receptionists by phone at 813-745-7899 or by email at HRReceptionists@moffitt.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.
If you'd like more information on your EEO rights under the law, please click here.
Created: 2024-06-07
Reference: 77722
Country: United States
State: Florida
City: Tampa
ZIP: 33637
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