Supv, Clinical Denials Mgmt
uf health systemGainesville (FL)
Supv, Clinical Denials Mgmt
Posted today
uf health systemGainesville (FL)
SENIORITY
Lead
About the role
Supervise clinical denials management operations for Hospital Billing (HB) and Professional Billing (PB), ensuring timely identification, clinical review, appeal, and resolution of denied claims. Provide frontline leadership to clinical denials staff, monitor productivity and quality, support evidence-based appeals, identify denial trends, and collaborate with clinical and revenue cycle partners to reduce avoidable denials and improve reimbursement.
Education:
Bachelor's degree in Nursing (BSN) or related healthcare field required. Associate degree in Nursing with equivalent relevant experience may be considered based on organizational requirements.
Experience:
Minimum of 2-3 years of progressive clinical denials, utilization management, clinical documentation, or related revenue cycle experience in a hospital or multi-site healthcare system. Minimum of 1�2 years of supervisory experience. Experience with HB/PB billing, Epic, and revenue cycle technologies strongly preferred. Demonstrated experience with clinical denials, appeals, and process improvement required.
License/Certification/Registration:
N/AOther Qualifications:� Demonstrated expertise in medical necessity, clinical validation, level-of-care, authorization, payer denials, appeals, and denial prevention strategies.� Strong knowledge of payer policies, clinical documentation requirements, utilization criteria, and healthcare revenue cycle workflows.� Proven leadership, coaching, performance-management, workload prioritization, and staff development skills.� Strong analytical and problem-solving abilities, including root-cause analysis, denial trend analysis, and data-driven decision making.� Excellent written and verbal communication skills with strong collaboration, organization, attention to detail, compliance, and stakeholder-management capabilities.
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