Appeals & Recovery Team Lead

Department

Patient Financial Services
Job Summary

In addition to being responsible for performing the standard duties & responsibilities of the Team Lead, Appeals-Recovery, this position functions in a lead support role assisting leadership in the areas of technical operations, personnel management, quality control and financial management, and assists with overseeing Managed Care, Commercial, Medicare HMO, and Medicaid HMO accounts within PFS, identified as denied or not processed according to the contract terms.

Required Qualifications

- Require a minimum of seven (7) years of managed care, reimbursement, or billing experience.
- Require an Associate's degree in related field; Bachelor's degree preferred.

Preferred Qualifications

- Prefer previous managerial experience.
- Prefer ability to type 30+ words per minute.
- Prefer demonstrated knowledge of computer applications and business systems to include analytical software and Microsoft Excel.
- Prefer demonstrated knowledge of ICD-10, CPT, HCPCS, DRG and Revenue codes.
- Prefer familiarity with Managed Care contracts, terms, protocols, procedures and operations.
- Prefer familiarity with state and federal rules regulations and guidance as related to managed care.

Required License and Certs

CRCS: Cert Revenue Cycle Specialist

Preferred License and Certs

CPB: Certified Professional Biller

CPC: Certified Professional Coder

Onsite position.

Employment Screening Requirements

As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/