Pharmacy Denials & Revenue Optimization Specialist

Baptist Health South Florida; Florida; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Career growth

Health resources

Tuition reimbursement

Wellness program

Job summary

Baptist Health South Florida is seeking an experienced Denials Management Specialist to identify and streamline the denials process, improving recovery efforts and productivity. You will review medical record documentation for overturning medication-related denials from insurers and act as a resource for Denials Management across departments.

You will maintain a comprehensive file of denials and communicate findings to teammates and management, collaborating with a multidisciplinary team to

Qualifications

• Experience in denial management and cash collections in a hospital setting.
• Review medical record documentation for denial overturns.
• Maintain files to communicate issues to teammates and management.
• Collaborate with multidisciplinary team to improve denial processes.

Responsibilities

• Identify and streamline denials process to improve recovery.
• Review medical record documentation for denial overturns.
• Maintain denial issue files for team communication.
• Work with multidisciplinary team to enhance denial management and appeals process.
• Increase cash collections for the department.

Skills

Analytical thinking

Critical thinking

Detail oriented

Problem solving

Interpersonal skills

Time management

Teamwork

Independent work

Education

Associates degree

Tools

Soarian

JDA

Workstation Lists

Microsoft Excel

Job description

Baptist Health South Florida is seeking an experienced Denials Management Specialist to identify and streamline the denials process, improving recovery efforts and productivity. You will review medical record documentation for overturning medication-related denials from insurers and act as a resource for Denials Management across departments.

You will maintain a comprehensive file of denials and communicate findings to teammates and management, collaborating with a multidisciplinary team to