Pharmacy Denial Specialist, System Infusion Pharmacy HUB, FT, 8a-4:30p

Job description

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.
What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we're all in.
At Baptist Health, we’re committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a “grow our own” philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:
• Career growth and development opportunities , with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible , reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.
Description:
Identify and streamline the denials process in an effort to improve and optimize the recovery efforts and maximize productivity. Assist with the review of medical record documentation for the overturning of medication-related denials generated by insurance companies. Serves as a resource for Denials Management and other departments within BHSF to proactively avoid unnecessary appeals. Responsible for maintaining a file containing all pertinent information on denials and issues in order to communicate all issues to teammates and management. Work closely with a multidisciplinary team to evaluate and improve the denial management, documentation and appeals process. Engages in activities that produce an increase in cash collections for the department.
Qualifications:
Degrees:
• Associates.

Additional Qualifications:
• Prior experience in pharmacy, corporate operational setting or hospital business office preferred.
• RPT, CPhT, PTCB certification recommended.
• Experience using Soarian, JDA, Workstation Lists and Microsoft Excel.
• Wide range knowledge manipulating and compiling information using multiple systems.
• Analytical, critical thinking, detail oriented, problem solving, and interpersonal skills required.
• Ability to manage multiple tasks and have excellent organization skills while working under pressure in order to meet stringent deadlines.
• Initiative, attention to detail, follow-through skills and ability to work independently and within a team based department.
• Excellent time-management skills.
• Interpersonal skills, professional conduct and communication skills to effectively gather information, ask questions and discuss problems with internal personnel.

Minimum Required Experience: 5 Years
EOE, including disability/vets