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Manager, Denials/Appeals/Recovery

Sarasota Memorial Health Care System

This leadership role oversees the daily operations of the Denials, Appeals, and Recovery department, modeling positive leadership and ensuring team and individual goals are achieved to support organizational objectives.

Candidates require at least a Bachelor's degree or equivalent work experience, with 10 years in managed care, appeals/denials, or reimbursement schedules, including 5 years writing appeals. Certification as a CPC or CCS by AHIMA is mandatory.

Preferred skills and knowledge include Medicare and Medicaid coverage protocols, leadership and team management, coding systems such as ICD-10, CPT, DRG, HCPCS, familiarity with insurance rules, Florida statutes on managed care, and strong communication, problem-solving, and independent judgment abilities.

Benefits include paid time off from day one, tuition reimbursement, discounted benefit plans, flexible spending accounts, life and disability insurance, retirement plan (403b), childcare discounts, bereavement leave, free parking, employee wellness screening and counseling, among others.

The position is onsite, Monday through Friday, at Sarasota Memorial Hospital, a highly ranked and Magnet designated facility noted for patient safety and excellence.

Requirements & Qualifications
  • Bachelor’s degree or equivalent experience
  • Minimum 10 years’ experience in managed care, appeals/denials, reimbursement schedules
  • Minimum 5 years writing appeals
  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification by AHIMA

Preferred:

  • Knowledge of Medicare NCD/LCD protocols and Advanced Beneficiary Notice (ABN)
  • Leadership and teamwork skills
  • Knowledge of ICD-10, CPT, DRG, HCPCS, revenue codes
  • Familiarity with insurance rules: Medicare, Medicaid, Managed Care, Commercial Insurance
  • Familiarity with Florida managed care statutes and contracts
  • Strong problem-solving, independent judgment, and communication skills
Benefits & Perks
  • Paid Time Off from day one
  • Tuition Reimbursement
  • Discounted Medical, Prescription, Dental, Vision Plans
  • Flexible Spending Accounts (Health Care and Dependent Care)
  • Life and Disability Insurance
  • 403b Retirement Savings Plan
  • Child Care Discounts and Before/After School Program
  • Bereavement Leave
  • Free Parking
  • On Campus Dining Discount
  • Employee Wellness Screening and Counseling
  • Employee Discount and Recognition Programs
  • Referral Programs
  • Opportunities for growth and advancement

Location

Florida, US

Employment Type

Full-time

Experience Level

Manager

Remote work allowed

No

Posted

1 week ago

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