Manager, Denials, Appeals & Recovery

Job Description


About the Opportunity


We've partnered with a nationally recognized health system in Florida to find an experienced Denials, Appeals & Recovery leader. This is a rare chance to step into a high-impact revenue cycle leadership role at one of the most respected healthcare organizations in the country.


Our client is:

• A top-ranked hospital system - #1 in its region per U.S. News & World Report
• Magnet®-designated for nursing excellence
• A consistent "A" rating for patient safety
• Nationally recognized for quality, patient experience, and workplace culture
• Ranked among the Top 10 World's Best Hospitals
• Named a Top 15 Most Desired Place to Work in the Nation

If you want your next move to be somewhere that's genuinely regarded as a destination employer, this is it.


The Role


You'll lead and develop a team of 10 specialists - including clinical denial nurses, coders, and underpayment/credit balance specialists - overseeing the full denials, appeals, and recovery operation. The department manages roughly $55M in denials, so your work directly protects the organization's financial health.


This role is about operational excellence and process improvement within an established, well-run department - not building from scratch. You'll be measured on what matters: denial overturn rate and cash recoveries.

Earnings


$90,000-$110,000 target (up to $120,000 DOE), plus annual bonus up to 15% Relocation: Assistance available for the right candidate salary

Location - In Office

• Sarasota, FL

Schedule

• • Monday-Friday, 8:00 AM-4:30 PM (onsite)

Job Type

Duties

• • Daily leadership of the Denials, Appeals & Recovery team
• • Analyzing denial trends to identify root causes and drive recoveries
• • Ensuring denied and underpaid accounts are worked timely and appropriately
• • Partnering with Managed Care on payer contracts and reimbursement strategy
• • Leading payer Joint Operating Committees and maintaining payer report cards
• • Coaching, developing, and supporting a tenured, specialized team

Requirements

• • 10+ years in managed care, appeals/denials, and/or reimbursement - including 5+ years in written appeals
• • Strong working knowledge of major payers - Aetna, UnitedHealthcare, and Florida Blue experience is a plus
• • Hospital/health-system experience required (facility size flexible - what matters is understanding hospital insurance, reimbursement, contracts, and policies)
• • Knowledge of Medicare NCD/LCD, ICD-10, CPT, DRG, HCPCS, and revenue codes preferred

License / Certification

• • Bachelor's degree (relevant experience may substitute year-for-year)
• • CPC or CCS certification (AAPC or AHIMA)

Benefits

• • Full benefits package

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