Revenue Cycle Medical Director — Peer-to-Peer & Authorizations

Moffitt Cancer Center; Tampa (FL); On-site; USD 114,000 - 174,000; Full time

Job summary

Moffitt Cancer Center in Tampa, FL seeks a Revenue Cycle Medical Director to oversee Peer to Peer Review, financial clearance and medical necessity checks. You will coordinate with payors and internal clinical teams to secure timely reimbursement and educate physicians on denials.

The role requires extensive knowledge of CMS regulations, payer policies and oncology billing, with leadership to guide the Financial Clearance unit and nursing staff.

Qualifications

• Bachelor’s degree in PA or APRN; MD may qualify but not required.
• At least 10 years of experience; 3+ years as PA/APRN.
• Knowledge of payor authorizations and peer to peer reviews.

Responsibilities

• Lead Peer to Peer Review and financial clearance for medically necessary services.
• Communicate with payors and clinical teams to obtain authorizations.
• Educate physicians on denials and payer policies.
• Maintain knowledge of CMS rules and reimbursement processes.

Skills

Communication

Leadership

CMS regulations

Payor processes

Problem solving

Education

Bachelor's degree in Physician Assistant / APRN

MD degree qualifies

Tools

Cerner Millennium

Soarian Financials

Oncore

Job description

Moffitt Cancer Center in Tampa, FL seeks a Revenue Cycle Medical Director to oversee Peer to Peer Review, financial clearance and medical necessity checks. You will coordinate with payors and internal clinical teams to secure timely reimbursement and educate physicians on denials.

The role requires extensive knowledge of CMS regulations, payer policies and oncology billing, with leadership to guide the Financial Clearance unit and nursing staff.