Join our dynamic team as an Enterprise Denial Analyst, where you will play a crucial role in analyzing and resolving technical denial claims while enhancing the financial performance of UF Health’s revenue cycle. Reporting to the Enterprise Technical Denial Assistant Manager, you will focus on minimizing denial rates and maximizing reimbursement at the enterprise level. Your contributions will involve a comprehensive investigation into denied payments through various means, including exploring patient admission details, reviewing payer contracts, examining historical denial patterns, and tracking emerging trends within payer practices.

In this position, you’ll be instrumental in fostering positive relationships with third-party payers by addressing inquiries and resolving complaints effectively. Collaborating closely with the Enterprise Technical Denial Assistance Manager and the Senior Denial Manager, you will also work hand-in-hand with the Enterprise Managed Care Department to tackle and troubleshoot atypical denial issues. Your well-rounded knowledge of relevant state and federal regulations will guide you through the complexities of contracts and the appeals process.

As a recognized expert in denial management, your mission will be to ensure that each denied claim is thoroughly and accurately processed from a technical and billing perspective. You’ll engage with various revenue cycle departments across the organization to develop best practices aimed at optimizing reimbursement and minimizing write-offs.

Qualifications:

Education & Experience:
– High school diploma required, with a minimum of four (4) years of experience in coding, billing, insurance follow-up, collections, or denial management in a hospital or clinical environment.
– An Associate’s degree or higher in a health or business-related field is preferred, along with three (3) years of relevant experience.

Knowledge, Skills, and Abilities:
You should possess a solid understanding of:
– Hospital billing and reimbursement processes
– Denial management and appeals procedures
– Third-party payer contracts
– Regulatory compliance in the healthcare sector (both federal and state)
– Exceptional critical thinking and analytical capabilities
– Meticulous attention to detail with the ability to work autonomously and deliver high-quality results
– Strong organizational and effective time management skills
– Superior writing and communication abilities
– Proficiency in Microsoft Office Suite (Outlook, Word, Excel)
– Knowledge of HIPAA regulations
– Competence in interpreting Explanation of Benefits (EOB) documents
– Strong research and problem-solving expertise
– Comfort with various computer systems

Licensure/Certification/Registration: Not required
Motor Vehicle Operator Designation: This position does not involve operating a vehicle for business purposes.