Appeals & Recovery Team Lead

Sarasota Memorial Health Care System; Sarasota (FL); On-site; USD 70,000 - 90,000; Full time

Job summary

Sarasota Memorial Health Care System is seeking a Team Lead, Appeals-Recovery within the Patient Financial Services department. You will support leadership in technical operations, personnel management, quality control, and financial oversight, focusing on managed care accounts deemed denied or not processed per contract terms.

Requirements include a minimum of seven years in managed care, reimbursement, or billing and an Associate's degree with a Bachelor's preferred.

Qualifications

• Minimum seven (7) years of managed care, reimbursement, or billing experience.
• Associate's degree in related field required; Bachelor's degree preferred.

Responsibilities

• Lead support role assisting leadership in technical operations, personnel management, quality control, and financial management.
• Oversee Managed Care, Commercial, Medicare HMO, and Medicaid HMO accounts within PFS (Patient Financial Services) as denied or not processed according to contract terms.

Skills

Typing 30+ wpm

Microsoft Excel

ICD-10 knowledge

CPT/HCPCS knowledge

Revenue codes knowledge

Education

Associate's degree in related field

Bachelor's degree preferred

Tools

Microsoft Excel

Job description

Department

Patient Financial Services

Job Summary

In addition to being responsible for performing the standard duties & responsibilities of the Team Lead, Appeals-Recovery, this position functions in a lead support role assisting leadership in the areas of technical operations, personnel management, quality control and financial management, and assists with overseeing Managed Care, Commercial, Medicare HMO, and Medicaid HMO accounts within PFS, identified as denied or not processed according to the contract terms.

Required Qualifications

• Require a minimum of seven (7) years of managed care, reimbursement, or billing experience.
• Require an Associate's degree in related field; Bachelor's degree preferred.

Preferred Qualifications

• Prefer previous managerial experience.
• Prefer ability to type 30+ words per minute.
• Prefer demonstrated knowledge of computer applications and business systems to include analytical software and Microsoft Excel.
• Prefer demonstrated knowledge of ICD-10, CPT, HCPCS, DRG and Revenue codes.
• Prefer familiarity with Managed Care contracts, terms, protocols, procedures and operations.
• Prefer familiarity with state and federal rules regulations and guidance as related to managed care.

Required License and Certs

CRCS: Cert Revenue Cycle Specialist

Preferred License and Certs

CPB: Certified Professional Biller

CPC: Certified Professional Coder

Onsite position.

Employment Screening Requirements

As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/