Florida Licensed Denials Director

Job Summary

Providing strategic leadership for denial management operations, the full-time Florida Licensed Denials Director will develop policies, oversee denial trend analysis, and manage payer relationships while working remotely.

Key responsibilities

• Develops and implements policies, procedures, and performance standards for denial investigation and appeals
• Oversees denial trend analysis and implements prevention strategies while ensuring compliance with regulatory requirements
• Leads and mentors denial management staff across multiple teams, collaborating with revenue cycle leadership on strategic initiatives

Required qualifications

• Bachelor's degree in finance, accounting, or healthcare administrative field
• 5+ years of progressive leadership experience in healthcare revenue cycle operations or related financial operations
• Comprehensive understanding of revenue cycle processes, including charge capture, billing, and reimbursement
• Expert knowledge of payer policies, denial processes, and appeal strategies
• Strong analytical skills with the ability to interpret complex data and drive strategic decisions