Florida Licensed Clinical Denials Manager
Job Summary
Managing daily operations of the clinical denials management team, the full-time Florida Licensed Clinical Denials Manager will supervise and develop specialists, analyze denial trends, and collaborate with clinical leadership to prevent denials, all while working remotely.
Key responsibilities
- Oversees team performance and ensures compliance with regulatory requirements
- Reviews and approves clinical appeals for accuracy and quality
- Identifies opportunities for process improvement and implements solutions
Required qualifications
- Bachelor's degree in Nursing or a related healthcare field
- Accredited Case Manager (ACM) or Registered Nurse (RN) license
- Strong knowledge of clinical documentation and medical terminology
- 2+ years in a supervisory or managerial position in a healthcare setting
- Comprehensive understanding of CPT, HCPCS, and ICD coding systems
Complete Job Description
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