What are the responsibilities and job description for the Denials & Appeals Manager - Revenue Cycle position at Networks Connect Healthcare Staffing?
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.
What You’ll Own
- 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
What You’ll Bring
- Bachelor’s degree (relevant experience may substitute year-for-year)
- 10 years in managed care, appeals/denials, and/or reimbursement — including 5 years in written appeals
- CPC or CCS certification (AAPC or AHIMA)
- 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
The Details
- Compensation: $90,000–$110,000 target (up to $120,000 DOE), plus annual bonus up to 15%
- Schedule: Monday–Friday, 8:00 AM–4:30 PM (onsite)
- Benefits: Full benefits package
- Relocation: Assistance available for the right candidate
Interested, or know someone who’d be perfect? Apply here. All conversations are confidential.
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Salary : $90,000 - $110,000