Pharmacy Denials Optimization Specialist

Baptist Health; Florida; Presencial; USD 60.000 - 85.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Career growth opportunities

Health and wellness resources

Tuition reimbursement

Wellness program with reduced deductib

Descripción de la vacante

Baptist Health is the region's largest not-for-profit healthcare organization, delivering patient-centered care across Miami-Dade, Broward, Palm Beach and surrounding counties. This role focuses on identifying and streamlining the denials process to maximize cash collections and improve recovery efforts.

The position requires an associates degree with preferred pharmacy or hospital revenue cycle experience, strong analytical and communication skills, and the ability to work under pressure as

Formación

• Associates degree required.
• Prior experience in pharmacy, corporate operational setting or hospital business office preferred.
• RPT, CPhT, PTCB certification recommended.

Responsabilidades

• Identify and streamline the denials process to improve recovery efforts and productivity.
• Review medical record documentation for overturning medication-related denials by insurance companies.
• Serve as a resource for Denials Management and other departments to proactively avoid unnecessary appeals.
• Maintain a file with all pertinent information on denials to communicate issues to teammates and management.
• Work with a multidisciplinary team to evaluate and improve denial management, documentation and appeals processes.
• Engage in activities that increase cash collections for the department.

Conocimientos

Analytical thinking

Detail oriented

Problem solving

Interpersonal skills

Time management

Organizational skills

Communication skills

Teamwork

Educación

Associates degree

Herramientas

Soarian

JDA

Workstation Lists

Microsoft Excel

Descripción del empleo

Baptist Health is the region's largest not-for-profit healthcare organization, delivering patient-centered care across Miami-Dade, Broward, Palm Beach and surrounding counties. This role focuses on identifying and streamlining the denials process to maximize cash collections and improve recovery efforts.

The position requires an associates degree with preferred pharmacy or hospital revenue cycle experience, strong analytical and communication skills, and the ability to work under pressure as