Remote Clinical Appeals Specialist - Reimbursement & Denials

Moffitt Cancer Center; Tampa (FL); Hybrid; USD 44,000 - 67,000; Full time

Job summary

Moffitt Cancer Center is hiring a Clinical Appeal Specialist to coordinate denials review and appeals in a remote-eligible role. You will manage reimbursement processes, analyze denials, and collaborate with payers to recover claims.

Qualified candidates have RN licensure, a relevant degree, and experience with Medicare/Medicaid policies. This full-time position offers on-site support while enabling virtual work options and a focus on oncology care.

Qualifications

• Associate's Degree in Healthcare, Finance, or related field.
• Bachelor's Degree plus five years healthcare experience with RN required (or Associate's plus seven years healthcare experience; RN preferred).
• RN license required.
• Accommodation: LPNs in the role may have time to obtain RN licensure.

Responsibilities

• Administer and coordinate denials review and appeals management processes.
• Conduct denials recovery and root cause analysis to identify improvements.
• Collaborate with care teams and payers to ensure compliant reimbursement.

Skills

Communication

Data analysis

Reimbursement knowledge

RN licensure understanding

Excel

Education

Associate's Degree

Bachelor's Degree

RN license

Tools

MS Office

MS Excel

MS Access

Soarian

Job description

Moffitt Cancer Center is hiring a Clinical Appeal Specialist to coordinate denials review and appeals in a remote-eligible role. You will manage reimbursement processes, analyze denials, and collaborate with payers to recover claims.

Qualified candidates have RN licensure, a relevant degree, and experience with Medicare/Medicaid policies. This full-time position offers on-site support while enabling virtual work options and a focus on oncology care.