Overview Work remotely while using your denial management expertise to make a direct impact on healthcare operations. 💻 Work Style: Remote 📍 Location Requirement: Must reside in Florida or Georgia 🕒 FTE: Full-Time (1.…
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Gainesville, Florida, United States · On-site
Entry level
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Full-time
high school, associate degree
Posted 28d ago
Apply by Aug 6
~40 hrs/week
Remote in Florida, United States, Georgia, United States
Responsibilities
The analyst is responsible for reviewing technical denial claims, submitting reconsiderations, and performing root cause analysis to optimize revenue cycle outcomes. They collaborate with various departments to resolve billing issues and maintain strong relationships with third-party payers.
Requirements
Candidates must have a high school diploma or GED, with an associate degree or higher preferred. A minimum of four years of experience in medical coding, billing, or denial management within a hospital or clinical setting is required.
Full job description
Overview
Work remotely while using your denial management expertise to make a direct impact on healthcare operations.
💻 Work Style: Remote 📍 Location Requirement: Must reside in Florida or Georgia 🕒 FTE: Full-Time (1.0 FTE)
Responsible for reviewing technical denial claims, submitting reconsiderations or appeals. Responsible to optimize the financial outcomes of revenue cycle through maintaining a low denial rate and high reimbursement rate at an enterprise level for UF Health. Initiates a root cause analysis of denied payment through comprehensive means including but not limited to: research of patient stays and treatment, review of payer contracts, analysis of historical denials, appeals and their outcomes, emerging trends in payer practices and requirements. Works to maintain third-party payer relationships, including responding to inquiries, complaints and other correspondence. Working in conjunction with the Enterprise Technical Denial Assistance Manager and Enterprise Sr Denial Manager, maintains a strong working relationship with the Enterprise ManagedCare Department to escalate and resolve atypical denial issues. Knowledgeable of state/federal laws that relate to contracts and to the appeals process. Considered a technical denial expert in denial management and ensures all denied claims are accurately worked from a technical/ billing perspective. Working in collaboration with the different revenue cycle departments through the enterprise to establish best practice solutions to maximize reimbursement and minimize organizational write-offs
Responsibilities
Key Responsibilities
Identifies, prioritizes, and resolves denied claims or initiates appeals to maximize reimbursement.
Interprets and applies payer contract terms, billing policies, and reimbursement guidelines.
Reviews and responds to EOBs, denial letters, appeal determinations, and documentation requests in a timely and professional manner.
Meets established productivity and quality standards while managing assigned denial workqueues.
Manages multiple payer workqueues, including Medicare, Medicaid, government, commercial, and Medicare Advantage plans.
Researches and resolves denials related to eligibility, registration, billing, documentation, and insurance follow-up, initiating timely appeals to prevent filing deadlines.
Evaluates accounts using remittances, denial reason codes, remark codes, and payer communications to drive claim resolution.
Prepares, submits, and follows up on appeals and reconsiderations to optimize reimbursement and protect organizational revenue.
Identifies payer-specific denial trends, escalates root causes, and recommends process improvements to reduce future denials.
Collaborates with revenue cycle teams to improve registration, charge capture, billing edits, and other upstream processes that prevent denials.
Monitors payer policy changes, identifies reimbursement risks, and ensures compliance with billing regulations and best practices.
Identifies and resolves at-risk accounts receivable to minimize revenue loss and meet contractual filing deadlines.
Qualifications
Minimum Qualifications
High School Diploma or GED required; Associate's degree or higher in a health or business-related field preferred.
Four (4) years of experience in medical coding, billing, insurance follow-up, collections, or denial management in a hospital or clinical setting.
Experience with medical coding, medical record review, auditing, or insurance processes preferred.
Experience supporting data governance, data quality, and security policies.
Strong skills in report and dashboard development.
Ability to monitor business intelligence tools, analyze performance, and recommend process improvements.
University of Florida Health is a world-class academic health center in Florida, encompassing hospitals, physician practices, colleges, centers, institutes, programs and services across northeast and north-central Florida.
UF Health represents the shared vision and commitment to patient care excellence of more than 22,000 employees of the University of Florida Health Science Center and UF Health Shands health care system.
Offices: 1600 SW Archer Rd, Gainesville, FL 32608, US · 1515 SW Archer Road, Gainesville, FL 32608, US · 1600 SW Archer Road, Gainesville, FL 32608, US · 655 West 8th Street, Jacksonville, FL 32209, US
How many Finance & Accounting jobs are open in Gainesville, FL right now?
There are currently 206 open finance & accounting positions in Gainesville, FL listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Gainesville, FL?
Companies currently hiring include UF Health, Symmetry Financial Group, H&R Block, Florida Credit Union, HUB International, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Gainesville, FL?
Yes — 62 of the 206 open finance & accounting positions offer remote or hybrid work (48 remote, 14 hybrid).
How do I apply for Finance & Accounting jobs in Gainesville, FL?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.