Remote Denial Recovery Analyst - Enterprise Reimbursement

UF Health; Gainesville (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

UF Health is seeking a remote denial management specialist to review and optimize denied claims, submit reconsiderations, and protect organizational revenue. This role requires deep knowledge of payer contracts, denial codes, and timely appeals to maximize reimbursement while maintaining low write-offs.

You will collaborate with the Enterprise Revenue Cycle teams and engage in root-cause analyses to drive process improvements across registration, billing edits, and upstream steps.

Qualifications

• High School Diploma or GED; Associate's degree or higher preferred.
• 4 years of experience in medical coding, billing, insurance follow-up, collections, or denial management in a hospital or clinical setting.
• Experience with medical coding, medical record review, auditing, or insurance processes preferred.
• Experience supporting data governance, data quality, and security policies.
• Strong skills in report and dashboard development.
• Ability to monitor business intelligence tools, analyze performance, and recommend process improvements.

Responsibilities

• Identifies, prioritizes, and resolves denied claims or initiates appeals to maximize reimbursement.
• Interprets and applies payer contract terms, billing policies, and reimbursement guidelines.
• Reviews and responds to EOBs, denial letters, appeal determinations, and documentation requests in a timely and professional manner.
• Meets established productivity and quality standards while managing assigned denial workqueues.
• Manages multiple payer workqueues, including Medicare, Medicaid, government, commercial, and Medicare Advantage plans.
• Researches and resolves denials related to eligibility, registration, billing, documentation, and insurance follow-up, initiating timely appeals to prevent filing deadlines.
• Evaluates accounts using remittances, denial reason codes, remark codes, and payer communications to drive claim resolution.
• Prepares, submits, and follows up on appeals and reconsiderations to optimize reimbursement and protect organizational revenue.
• Identifies payer-specific denial trends, escalates root causes, and recommends process improvements to reduce future denials.
• Collaborates with revenue cycle teams to improve registration, charge capture, billing edits, and other upstream processes that prevent denials.
• Monitors payer policy changes, identifies reimbursement risks, and ensures compliance with billing regulations and best practices.
• Identifies and resolves at-risk accounts receivable to minimize revenue loss and meet contractual filing deadlines.

Skills

Denial management

Medical coding

Billing follow-up

Data governance

BI & dashboard development

Research denials

Education

High School Diploma or GED

Associate's degree or higher in health or business-related field

Job description

UF Health is seeking a remote denial management specialist to review and optimize denied claims, submit reconsiderations, and protect organizational revenue. This role requires deep knowledge of payer contracts, denial codes, and timely appeals to maximize reimbursement while maintaining low write-offs.

You will collaborate with the Enterprise Revenue Cycle teams and engage in root-cause analyses to drive process improvements across registration, billing edits, and upstream steps.