Authorization Denials & Payor Relations Specialist

Shriners Children's; Tampa (FL); On-site; USD 45,000 - 65,000; Full time

Job summary

Shriners Children’s in Tampa, FL is seeking an Authorization Denials Representative to manage payer denial and appeal follow-up. You will verify documentation, coordinate with third-party payers, and support UR processes to ensure timely payments.

The role requires 1-3 years in healthcare revenue cycle, knowledge of 837I/837P/835/EOB, and strong data tracking skills. A Bachelor’s degree is preferred; Epic EMR experience and SQL/Crystal Reports are valued. Training will be provided.

Qualifications

• 1-3 years of healthcare revenue cycle experience.
• Knowledge of 837I, 837P, 835 and EOB responses.
• Understanding of insurance contract rates and terms.
• Experience with registration and authorization processes.

Responsibilities

• Coordinates payer denial and appeal follow-up activities to ensure appeals are on file and processed.
• Maintains the healthcare tracking tool and provides end-user training.
• Collects and analyzes reports on denial activity and distributes findings.
• Assists with data preparation for committee reviews and UR coordination.

Skills

Healthcare revenue cycle

Payer denial follow-up

Data analysis

Communication with payers

UR coordination

Education

Bachelor's degree

High School Diploma or GED

Tools

Epic EMR

SQL

Crystal Reports

Job description

Shriners Children’s in Tampa, FL is seeking an Authorization Denials Representative to manage payer denial and appeal follow-up. You will verify documentation, coordinate with third-party payers, and support UR processes to ensure timely payments.

The role requires 1-3 years in healthcare revenue cycle, knowledge of 837I/837P/835/EOB, and strong data tracking skills. A Bachelor’s degree is preferred; Epic EMR experience and SQL/Crystal Reports are valued. Training will be provided.