University of Florida - UF

Title: Insurance Claims Specialist | Patient Financial Services Location: Gainesville United States Job Description: - Office and Clerical - 63499 Job Description Overview Bring your claims expertise to a remote team committed to service excellence and operational success. Work Style: Remote Location Requirement: Gainesville, FL FTE: Full-Time (1.0 FTE) This position is responsible for coordinating incoming and outgoing payer correspondence, reviewing claim documentation, supporting Epic account updates, and ensuring accurate claim processing and routing. Ideal candidates are detail-oriented, analytical, and thrive in a fast-paced environment while helping drive efficiency and accuracy across the revenue cycle team. Responsibilities Key Responsibilities - Manage incoming insurance payer correspondence, ensuring documentation is accurately reviewed, sorted, and prepared for scanning - Coordinate outgoing mail and fax communications to patients and insurance payers in support of Insurance Claims Specialists - Review and evaluate paper claims to ensure proper handling and routing - Maintain accurate account documentation and correspondence updates within Epic - Analyze large volumes of payer and demographic information to identify trends, discrepancies, and updates - Support revenue cycle operations through strong attention to detail, organization, and process accuracy - Work collaboratively with team members to ensure timely and efficient claims support activities - Maintain knowledge of insurance processes, payer requirements, and operational workflows while supporting the financial integrity of UF Health Qualifications Education - High School Diploma/Equivalent Required Skills & Qualifications - Minimum of six (6) months of billing experience within a hospital or physician practice setting, or one (1) year of experience in a business environment involving finance, accounting, or insurance portal systems - Experience verifying patient insurance eligibility and working with commercial, including BCBS, United, Aetna, Cigna and other commercial payors. - Epic experience preferred, with familiarity using computerized insurance billing systems and Microsoft Office programs preferred - Strong communication, organizational, and problem-solving skills with the ability to work independently in a fast-paced environment - Above-average math aptitude with strong attention to detail and accuracy - Ability to interact professionally with payers, and internal teams while exercising sound judgment in account resolution - Knowledge of medical terminology preferred - Demonstrated ability to consistently achieve performance expectations while managing multiple priorities under pressure

• Lead large-scale, high-complexity HubSpot implementation projects, ensuring alignment with strategic and tactical business goals. • Identify and recommend complementary services to expand scope; provide scoping, quotes, and direction for implementation. • Stay informed on industry trends and HubSpot’s competitive position to keep client strategies cutting-edge. • Translate client and internal strategies into comprehensive HubSpot solutions supporting marketing, sales, customer success, and operational workflows. • Provide intermediate to advanced configuration of HubSpot Marketing Hub, Sales Hub, Service Hub, Content Hub, Data Hub, and HubSpot AI. • Own the strategy and configuration of native HubSpot integrations (e.g., Salesforce, Microsoft Dynamics, NetSuite) with expertise in sync rules, field mapping, and conflict resolution. • Revenue Engine Optimization: Design and implement data schema, custom objects, and property mapping aligned to the client’s RevOps strategy. • Build and optimize revenue engine components including lead scoring, advanced attribution, and automated marketing-to-sales-to-service hand-off sequences. Build complex RevOps dashboards that demonstrate clear ROI to stakeholders. • Data Governance: Implement data governance best practices including deduplication logic and hygiene standards to maintain HubSpot as a reliable single source of truth. • Provide training to clients and internal teams on how to use their customized HubSpot instance effectively; offer ongoing support and troubleshooting assistance. • Obtain your HubSpot Trainer Certification and help onboard clients to the platform. • Configure HubSpot instances from the ground up, including custom objects, property mapping, and data schema aligned to client specifications. • Translate business requirements into scalable HubSpot configurations that support the full customer lifecycle. • Business Process Mapping: Conduct technical discovery to map "Current State" vs. "Future State" processes, identifying technical bottlenecks in the revenue funnel. • Guide and mentor CRM Specialists and support Marketing Strategists on complex projects. • Collaborate cross-functionally to align CRM solutions with broader business objectives. • Champion knowledge sharing and process optimization within the team. • Monitor and manage project budgets and scope; track and meet effective billing rate (EBR) goals. • Work with the internal SmartBug team to ensure quality work is delivered to clients. • Create and follow processes that result in differentiated client results and quality.

• Develop and execute a customer success strategy for clients that meets their stated business goals—demonstrating ROI for your clients should be your North Star • Ensure your clients see SmartBug as an indispensable partner in their growth, and that each receives a 5-star customer experience as measured by being the highest-rated partner on the HubSpot partner directory—your clients should be happy to be a reference • Deliver consistent, world-class quality across all customer success strategies and implementations • Have a strong understanding of strategic opportunities to expand retainer scope and present ideas to Marketing and CRM teams as well as internal teams • Stay informed about the latest industry trends, market developments, competitive landscape, and HubSpot’s competitive position to ensure the clients’ customer success strategies remain cutting-edge and effective • Gather and relay customer feedback to the client’s product development team to drive product improvements • Monitor customer satisfaction and implement retention strategies • Identify satisfied customers who can serve as advocates for the client through case studies, testimonials, or referrals • Optimize client’s Service Hub instances as well as execute the strategy in HubSpot • Work with creatives to create and curate customer collateral, presentations, and other content pieces to support your clients’ customer base

• Deliver professional translation services on an ongoing monthly basis. • Translations will be from English to French Canadian or French Canadian to English.

Title: Denial Recovery Coding Analyst | Enterprise Denial Management Locations: FL, GA, PA, NC, SC, TN, or TX Work Type: Remote, Full Time Job ID: 57859 Job Description: Overview Work remotely while using your denial management expertise to make a direct impact on healthcare operations. Turn insights into impact-driving coding accuracy, reducing denials, and maximizing reimbursement across the enterprise. Work Style: Remote Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX) FTE: Full-Time (1.0 FTE) Responsible for maintaining low denial rates and optimizing reimbursement across the enterprise by ensuring high coding standards and effective denial management practices. Leads and supports initiatives to improve coding accuracy, reimbursement outcomes, and appeal turnaround times. Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies opportunities for performance improvement and implements strategies to enhance revenue cycle outcomes. Educates departments on appropriate charging, billing, and coding practices to ensure regulatory compliance. Collaborates with Managed Care, Compliance, and operational teams to resolve complex issues with departments and payers, driving sustainable improvements in reimbursement and denial prevention. Responsibilities Key Responsibilities: - Manages clinical denials from assigned work queues, including claim resubmissions, authorization verification, payer reprocessing, reconsiderations, and appeals - Partners closely with Managed Care and payers to reduce denials and improve reimbursement outcomes - Analyzes denial trends and develops recommendations to improve coding accuracy and documentation practices - Meets established productivity and accuracy standards, including reviewing approximately 30 accounts per day with a 98% accuracy rate - Applies coding guidelines (NCCI, ICD-10, CPT, HCPCS, CMS) to accurately review, code, and correct accounts - Collaborates with department managers to track, report, and resolve denials, including participating in audits and compliance reviews - Identifies root causes of denials, tracks trends, and escalates findings to leadership for follow-up and process improvement - Works across multiple payer work queues, including Medicare, Medicaid, government, and commercial payers - Research denials related to authorization, medical necessity, non-covered services, coding, and billing issues, ensuring timely resolution and appeal submission - Prepares and submits detailed, well-supported reconsiderations and appeals based on medical record review and payer requirements - Monitors payer communications and policy updates to identify risks impacting reimbursement and authorization requirements - Reviews and corrects coding, including modifier usage, diagnosis sequencing, and compliance with coding guidelines - Reviews and adjusts charges as needed based on documentation, billing, and regulatory standards - Educates departments on denial prevention strategies, including improvements in coding, charging, and authorization processes Qualifications Minimum Qualifications: - High School Diploma or GED required - One of the following coding certifications required: CPC, COC, RHIT, RHIA, or CCS - 1-2 years of coding experience, along with 1-2 years of denial management and/or insurance-related experience

• Build SEO services and best practices, including keyword research, website SEO audits, implementing Schema, link building, SEO analytics, and implementation of all on-page and off-page SEO activities • Conduct SEO audits of client website performance • Map content strategies to the buyer journey, identifying gaps and prioritizing high-impact topics for organic acquisition. • Develop detailed SEO content briefs, including semantic clusters, recommended structure (Hn), internal linking, and on-page optimizations. • Build analytics reports on keyword and site rankings, site domain performance, backlinks, on-page performance, and organic traffic trends • Diagnose and resolve organic traffic and SEO issues • Set up proper performance tracking on-site domains • Implement Google Search Console and Google Analytics • Inform client services and web team of algorithm updates and SEO news • Advise on best practices around domain, sub-domains, and site architecture • Provide expertise as needed for complex SEO problems/opportunities • Other responsibilities as assigned.

Title: Coder Physician Billing | Revenue Cycle - Team 5 - Surgery Location: FL, GA, MO, PA, SC, NC, TN, or TX United States Job Description: Overview Coder, Physician Billing Ensure accurate coding and support compliant, efficient billing-playing a key role in optimizing revenue cycle performance. Work Style: Remote Location Requirement: Must reside in an approved state (FL, GA, MO, PA, SC, NC, TN, or TX) FTE: Full-Time (1.0 FTE) Reviews and analyzes medical records to assign accurate diagnostic and procedural codes in compliance with established coding guidelines and organizational policies. Collaborates with healthcare providers to clarify documentation, resolve coding discrepancies, and ensure the integrity of coded data for billing and reporting purposes. Maintains current knowledge of coding standards, including ICD, CPT, and HCPCS, and supports the billing process by providing precise coding for claims submission. Participates in auditing activities, supports staff training on coding procedures, and monitors productivity and quality metrics to drive continuous improvement. Responsibilities Key Responsibilities: - Reviews and analyzes medical records to assign accurate diagnostic and procedural codes - Ensures compliance with coding guidelines and organizational policies - Collaborates with healthcare providers to clarify documentation and resolve discrepancies - Maintains the integrity of coded data for billing and reporting purposes - Supports the billing process by providing accurate coded information for claims submission - Conducts audits and monitors productivity and quality metrics to drive performance improvement - Assists in training staff on coding procedures and updates Qualifications Education: - High School Diploma - Required Certification / Licensure: - Certified Professional Coder (CPC) - Required at time of hire - Please note: CPA-A does not meet the certification requirements for this role. - 3+ years of experience in medical coding or health information management - Knowledge of ICD-10-CM, CPT, and HCPCS coding standards - Experience reviewing medical records and assigning accurate codes - Strong attention to detail with a focus on compliance and regulatory requirements - Ability to collaborate with healthcare providers to clarify documentation and resolve discrepancies

Title: Denial Recovery Analyst | Enterprise Denials Job Description: Work Style: Remote Location Requirement: Must reside in Florida or Georgia FTE: Full-Time (1.0 FTE) Responsible for reviewing technical denial claims and submitting reconsiderations and appeals to ensure accurate and timely reimbursement. Optimizes financial performance within the revenue cycle by maintaining low denial rates and maximizing recovery across the enterprise. Conducts root cause analysis of denied payments through comprehensive review of patient encounters, payer contracts, historical denial trends, and appeal outcomes. Maintains strong relationships with third-party payers, responding to inquiries, disputes, and correspondence. Collaborates with Enterprise Technical Denial Assistance leadership and Managed Care to escalate and resolve complex denial issues while ensuring compliance with state and federal regulations. Serves as a subject matter expert in denial management, partnering with revenue cycle teams to implement best practices that improve reimbursement and reduce organizational write-offs. Responsibilities Key Responsibilities - Identify, prioritize, and resolve denied claims, including initiating timely appeals and reconsiderations - Interpret and apply payer contract terms to ensure accurate claim resolution and reimbursement - Conduct internal and external correspondence clearly, professionally, and in compliance with organizational standards - Review and take appropriate action on EOBs, denial letters, appeal determinations, and documentation requests in a timely manner - Meet productivity and accuracy standards, including working an average of 60 accounts per day with a 98% accuracy rate - Manage and work multiple payer workqueues, including Medicare, Medicaid, government, commercial, and Medicare Advantage plans - Research and resolve denials related to eligibility, registration, billing errors, missing information, and documentation requests - Initiate and follow up on appeals to prevent timely filing denials and ensure optimal reimbursement outcomes - Evaluate accounts and drive resolution using tools such as remittance advice, denial codes, and payer communications - Identify payer-specific denial trends and escalate findings to leadership with actionable insights for root cause analysis - Collaborate with revenue cycle teams across the enterprise to recommend process improvements and prevent future denials - Review payer policies and communications to identify risks to reimbursement and stay current on regulatory and industry best practices - Proactively identify and resolve at-risk A/R to minimize revenue loss and ensure compliance with contractual deadlines Qualifications Minimum Qualifications - High School Diploma or GED required - Minimum of four (4) years of experience in billing, insurance follow-up, collections, or denial management within a hospital or clinical setting Preferred Qualifications - Associate's degree or higher in a health or business-related field - Experience in coding, medical record review, auditing, or insurance-related functions - Experience supporting data governance and security policies - Strong skills in report and dashboard development - Ability to monitor BI tools and recommend process improvements

• Retention & Health Ownership: Own the Net Retention Rate (NRR) and Gross Retention Rate (GRR) metrics. Develop proactive "Early Warning Systems" to identify and pivot accounts at risk. • HubSpot Partnership Stewardship: Own the executive-level relationship with the HubSpot partner ecosystem to maximize the use of HubSpot resources. • Relationship Stickiness: Design frameworks that move AMs from "order takers" to "strategic partners," ensuring we are embedded in the client’s long-term business roadmap. • LTV Optimization: Analyze client lifecycles to maximize value, identifying opportunities for expansion and reducing churn through superior service delivery. • Account Planning & Quarterly Business Reviews (QBRs): Standardize and oversee the QBR process across the AM team. Ensure that every QBR translates technical milestones into business ROI that resonates with a client’s C-suite. • Commercial Growth: Own the "Expansion" portion of Net Revenue Retention. Partner with Sales and Strategy to identify whitespace within the existing portfolio. • Commercial & Scope Governance: Partner with the VP of Operations to monitor and optimize the Effective Billing Rate (EBR) across the client portfolio. • Team Architecture: Oversee the entire Account Management vertical. Recruit, mentor, and scale a team capable of managing complex, high-touch relationships. • The "SmartBug Way" Standardization: Define and refine the Client Journey Map from handoff to renewal. • Performance Metrics: Define and track KPIs beyond just revenue—focusing on NPS/CSAT, client health scores, and referral rates. • The "Golden Triangle": Work in lockstep with the VP of Strategy and the PMO/Delivery Leaders. • High-Level Resource Advocacy: Act as the primary advocate for the client portfolio during internal resource allocation and capacity planning sessions. • Feedback Loops: Act as the "Voice of the Client" internally. • CRM Mastery: Use HubSpot as the single source of truth. • Data-Driven Decisions: Use HubSpot data to forecast churn risks and identify "expansion-ready" accounts. • AI Adoption: Champion internal AI fluency to streamline client communication and reporting.

Title: IT Applications Analyst II (PACS) | IT Applications - Clinical | Durbin Job Description: Overview Work Location: Hybrid role with a strong need for onsite support during the initial transition period. Analyzes application requirements and designing solutions to improve system functionality. Collaborates with cross-functional teams to implement and test software applications, troubleshooting issues to maintain optimal performance, and documenting processes for user reference. Supports end-users through training and inquiry resolution, monitors application performance, and recommends efficiency improvements. Coordinates with vendors for software updates and assisting in the development and execution of deployment plans. Responsibilities Key Responsibilities: - Analyze application requirements and design solutions to enhance system functionality - Collaborate with cross-functional teams to implement and test software applications - Troubleshoot system issues to maintain optimal performance and reliability - Document processes, workflows, and procedures for user reference and system consistency - Provide end-user support through training and timely resolution of inquiries - Monitor application performance and recommend improvements to increase efficiency - Coordinate with vendors on software updates and assist with deployment planning and execution Qualifications Minimum Qualifications: - Minimum of two (2) years of experience in application support or application training - Experience analyzing and supporting IT applications - Strong skills in software testing, troubleshooting, and performance monitoring - Ability to provide effective end-user training and support - Experience coordinating with vendors for system updates and deployments - Knowledge of application security standards and compliance requirements Preferred Qualifications: - Three (3) or more years of experience in application analysis, content build, or project management within the applicable application or Epic module - Advanced experience supporting and optimizing IT applications in a healthcare environment - Experience with system configuration, workflow analysis, and performance improvement initiatives