AdventHealth Executive Medical Director Denials Management in Altamonte Springs, Florida
Executive Medical Director
Location Address: 2600 Lucien Way, Maitland, FL 32751
Top Reasons to Work at AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
- Full-Time, Monday – Friday
You Will Be Responsible For:
Providing physician review of post-remittance denials, writing and submitting clinical denial appeals when required
Performing peer-to-peer discussions with payer medical directors and/or discussing cases with payer representatives to facilitate claim resolution and build payer relationships
Utilizing clinical knowledge and experience, information science, data analysis, and interpersonal skills to support and represent the optimal denials recovery and prevention processes identified with all medical, clinical and ancillary departments
Researches and responds to denials in a timely fashion and identifies trends through data analysis
Responds to identified trends by recommending changes in practice and/or provider documentation to promote denial prevention initiatives
Serves as a subject matter expert, providing clinical expertise and business direction in support of best practice, world class denial management and prevention strategies
Adheres to AdventHealth Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.
What You Will Need:
Graduate from medical school and residency program
Five years recent clinical practice experience
Seven years of leadership experience
Current, valid state license as a physician
Board certified and eligible for membership on the Hospital medical staff
The Denials Management Executive Medical Director is an integral member of the centralized denial management team who provides physician review of post remittance clinical denials and supports optimal denials recovery and prevention processes through their clinical knowledge and experience. The Denials Management Executive Medical Director educates, advises, and informs members of the Denial Management, Revenue Cycle, Managed Care, and applicable Medical Staff leaders of specific issues and prevention initiatives related to clinical denial management.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.