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Appeals Specialist

Florence, SC
TRACKING CODE

4617

JOB DESCRIPTION

1.Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values. 2.Ability to manipulate data in spreadsheets in order to report trends and statuses to Manager. 3.Investigate, determine, pursue, and overturn with accuracy and timeliness denied accounts by insurance payers. Thoroughness and reliability are essential because of the nature of the work and for credibility with the payers. 4.Negotiate and insist accountability with third party payers on accounts through accurate and timely follow-up. 5.Document precisely and timely in contract management software. 6.Utilize available resources (online websites, contract management software, payer contacts) to aid in the expedient recovery of denied funds. 7.Maintain a high level of professionalism while aggressively overturning denied claims by third party payers. 8.Must be flexible, able to work independently and able to achieve deadlines and deliverables with minimal supervision. 9.Perform other duties as assigned by Manager. 10.Read and understand payer explanation of benefits or remittance advice to appropriately resolve denials. 11.Excellent written and oral communication skills. 1.Working knowledge of billing/coding terminology (e.e ICD-10, CPT, Revenue Code) 2.Working knowledge of Patient Financial Services 3.Procedural knowledge of account receivable management 4.Understanding of basic revenue cycle 5.Excellent interpersonal, written and organizational skill required 6.Experience with problem solving techniques 7.Minimum of one year healthcare appeals experience is preferred. Minimum of two years’ experience with Excel and Word.

 

Licenses/Certifications/Registrations/Education: Minimum of a High school Diploma/GED from an accredited school plus 2 years of experience in patient financial services required.

WORK SCHEDULE

Full time

JOB LOCATION

Florence, SC, United States

POSITION TYPE

Full time

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