Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials

UF Health; Gainesville (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization in Gainesville, Florida is seeking a professional to manage the daily operations of its patient financial services team. This role involves overseeing all payer denial activities, ensuring accurate billing, and collaborating with various departments to improve processes. The ideal candidate will have 3-5 years of experience in coding or denial management, strong leadership skills, and relevant certifications (CPC, COC, RHIT, RHIA, or CCS). This position offers opportunities for significant impact in revenue cycle management.

Qualifications

• Knowledge of third-party contracts and insurance protocols.
• Experience with federal and state healthcare regulations.
• Proven track record in conflict resolution.

Responsibilities

• Manage daily operations of the patient financial services team.
• Oversee payer denial activities to support low denial rates.
• Establish departmental goals and measure effectiveness.
• Perform denial trend analysis for process improvements.
• Collaborate with teams to educate departments on compliance.

Skills

Knowledge of hospital billing and reimbursement processes

Ability to identify problems and develop solutions

Strong time-management skills

Leadership abilities

Exceptional communication skills

Proficiency with Microsoft Office applications

Education

High School Diploma or GED

Associate’s degree in a healthcare or business-related field

Tools

Epic system

Job description

Overview

Manages the daily operations of the patient financial services team to ensure accurate and efficient billing and collections. Coordinates with healthcare providers and insurance companies to resolve billing issues and expedite payments. Monitors patient accounts for compliance with financial policies, trains staff on handling inquiries and payment plans, and implements process improvements to optimize revenue cycle management. Requires reviewing financial reports to identify trends and collaborating with other departments to streamline patient registration and insurance verification, all while maintaining strict confidentiality and data protection standards.

Responsibilities

• Manage and oversee all payer denial activities to support low denial rates and optimal reimbursement.
• Direct daily operations of the denial management process and identify opportunities for workflow and process improvements.
• Establish departmental goals, measure process effectiveness and productivity, and identify the need for updated policies and procedures.
• Plan and organize projects aimed at improving billing effectiveness, reimbursement rates, and appeal turnaround times.
• Perform denial trend analysis, including:
  • Epic system edits
  • Coding validation
  • Charge Description Master (CDM) processes impacting reimbursement
  • Authorization trends and performance improvement
  • Payer-specific denial trends
• Collaborate with the Enterprise Clinical Denial Assistant Manager to educate departments on proper charging, billing, and coding practices to ensure regulatory compliance.
• Partner with Managed Care and Compliance teams to resolve issues involving departments and payers.
• Report to the Enterprise Senior Denial Manager.
• Provide support across the revenue cycle, including:
  • Clinical departments
  • Patient Financial Services
  • Revenue Integrity
  • Managed Care
• Lead and support the Clinical Denial team.

Qualifications

Required Education

• High School Diploma or GED

Preferred Education

• Associate’s degree in a healthcare or business-related field

Necessary Skills

1. Demonstrated knowledge of hospital billing and reimbursement processes, including denials and appeals, third‑party contracts, insurance protocols, delay tactics, systems, and workflows, as well as federal and state healthcare regulations.
2. Ability to take initiative by identifying problems, developing solutions, and implementing process improvements.
3. Strong time‑management skills with the ability to multitask effectively in a fast‑paced environment with tight deadlines.
4. Proven leadership abilities, including conflict resolution and excellent customer service skills.
5. Exceptional written and verbal communication skills.
6. High level of proficiency with computer systems, including Microsoft Office applications (Word, Excel, Outlook, PowerPoint).

Required Licensure/Certifications

• One of the following certifications is required: CPC, COC, RHIT, RHIA, or CCS

Preferred Licensure/Certifications

• Not applicable

Required Experience

• Three (3) to five (5) years of experience, including:
  • Minimum of three (3) years of coding, insurance, or denial-related experience
  • Minimum of three (3) years of management experience

Supervision

• Supervisory Responsibility: Yes
• Number of Employees Supervised: 1–5

Age of Patients Served

• Not applicable