Denials Specialist - Medical Bill Audit

• High School Diploma or GED
• Three (3) years billing and/or collection experience working in a medical setting.

Skills & Abilities:

• Working knowledge of hospital billing, collections, receivables processing, and payer requirements related to denials and refunds.
• Proficiency in Microsoft Excel and PowerPoint, with the ability to support reporting, tracking, and presentation needs.
• Ability to consistently perform work with a high level of accuracy, ensuring accounts and referrals are processed correctly and timely.
• Strong verbal and written communication skills, including effective telephone etiquette when following up with vendors, attorneys, and internal stakeholders.
• Ability to manage multiple tasks, meet deadlines, and consistently complete assignments to successful conclusion.
• Ability to work cooperatively with team members, provide support as needed, and contribute to a positive and productive team environment.

Under the direction of the Dir Denial & Medical Bill Audit, the Denials Specialist provides operational and administrative support to the Denials Team to ensure accurate, timely, and consistent handling of denial‑related activities. This role is responsible for reviewing denial and refund work queues, routing accounts to the appropriate queues, supporting attorney and vendor referrals, reviewing correspondence, and providing ongoing assistance to team members as needed. The Denials Specialist demonstrates reliability, attention to detail, and a clear understanding of departmental objectives, policies, and procedures. All duties are performed in accordance with Tampa General Healthcare's mission, vision, and values, with a focus on supporting revenue integrity and customer service excellence.

Essential Functions:

• Reviews the Denials and Refund work queues and routes accounts to the appropriate queues in accordance with established procedures.
• Provides follow‑up and support related to attorney and vendor referrals, ensuring timely documentation and tracking.
• Reviews correspondence related to denials, refunds, and appeals and distributes information appropriately to support team workflows.
• Maintains timely and accurate reporting of legal and vendor referrals.
• Provides administrative and operational support to the Denials Team as needed to ensure continuity of operations.
• Monitors and reports issues impacting cash flow and participates in performance improvement initiatives.
• Utilizes Excel and PowerPoint to support data tracking, reporting, and presentations.
• Communicates professionally and effectively with internal departments, vendors, attorneys, and other stakeholders.
• Assists with training and onboarding of new team members by sharing knowledge and providing feedback as requested.
• Performs all duties in compliance with departmental policies and Tampa General Healthcare’s mission, vision, and values.