REIMBURSEMENT RECOVERY SPECIALIST

Summary

The Reimbursement Recovery Specialist is responsible for securing the payment of medical claims in a timely and efficient manner to ensure the financial health of H. Lee Moffitt Cancer Center. This role involves analyzing, identifying, and resolving barriers, monitoring unpaid claims, appealing administrative denials, and reviewing credit balances and payer payments.

Responsibilities

• Analyze, identify, and resolve barriers to claim payment
• Monitor and resolve unpaid claims
• Appeal administrative denials and clinically appealed claims
• Review and manage credit balances and payer payments
• Manage payer refund requests for appropriateness and appeal/contest when applicable
• Protect and defend contract terms, Letters of Agreement, and Rate Agreements

Requirements

• Minimum of three (3) years recent medical collections experience in a hospital or large group practice setting
• Proficiency with Microsoft Office – Word, Outlook, and Excel
• Knowledge of Commercial/Managed Care contract payer reimbursement methodology, calculations, and language
• Ability to manage multiple, competing priorities
• Effective oral and written communication skills
• Assertiveness, high motivation, and ability to work independently
• Excellent time management and organizational skills
• Proficiency in computer skills (speed and accuracy)

Preferred Education and Experience

• Associate's Degree in Healthcare Administration, Accounting, Business, Finance, or other relevant discipline
• Experience with commercial payors, including eligibility inquiries and Denials Management
• Billing and claim submission experience, preferably on a UB04

Salary Range

The salary range for this position is $21.12 - $32.24 per hour. Actual compensation may vary based on location and a variety of job-related factors, including experience, skills, education, and internal equity among Team Members in similar positions.

Equal Employment Opportunity

Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status.