Appeals Coordinator
3.
4 Sellersville, PA Sellersville, PA Full-time Full-time $19 - $23 an hour $19 - $23 an hour 14 days ago 14 days ago 14 days ago Under the general direction of the Manager of Case Management, the Appeals Coordinator manages the third party appeal process.
The Appeals Coordinator is responsible for maintaining and updating correspondences and receipt acknowledgments within files and database.
Job Duties:
Process third party denials/appeals upon notification of an insurance denial, either by the Case Manager or the insurance company.
Manages third party appeals and denials in the Case Management and Meditech databases in order to provide accurate reporting at various hospital committees.
Completes data entry for all Denial and Appeal Management processes.
Maintains all correspondences and receipt acknowledgments to ensure receipt by payors.
Coordinates the telephonic and written appeal processes with Case Management staff, Physician advisors and payors.
Manages the Retro Appeal process for the department (RAC, MAC, QIC, Commerical payors, etc).
Assists in the build and maintenance of department databases as needed.
Prepares and analyzes reports using Excel and department software for department and committee reporting.
Works with Business Office to investigate and resolve outstanding utilization review/reimbursement issues.
Participates as a team member in establishing procedures relating to Case Management functions to promote efficient operations.
Demonstrates ability to prioritize work assignments in order to meet deadlines and maintain timely department operations.
Performs Case Management Technician's functions in her absence to ensure continuity in Case Management department.
Communicates denial trends to Case Management leadership.
Education and
Experience:
HS Diploma/GED and 1-3 years Business experience of health Care Billing experience.
Prefer knowledge of Billing, Case Management Coding, Pre-certification, contracts, financial account reconciliation and insurance Payor regulations (Commercial and Government)
Benefits:
Medical, Free Dental, Vision Insurance for full time and part time 403B Pension Plan On-site discounted Child Care Center Tuition Reimbursement up to $5250 per year Free Life Insurance Free Parking Paid Time Off Sick Time Flexible Spending Accounts Employee Referral Bonus Job Type:
Full-time Pay:
$19.
00 - $23.
00 per hour Expected hours:
40 per week
Benefits:
401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule:
Day shift Monday to Friday Work setting:
Hospital Education:
High school or equivalent (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
4 Sellersville, PA Sellersville, PA Full-time Full-time $19 - $23 an hour $19 - $23 an hour 14 days ago 14 days ago 14 days ago Under the general direction of the Manager of Case Management, the Appeals Coordinator manages the third party appeal process.
The Appeals Coordinator is responsible for maintaining and updating correspondences and receipt acknowledgments within files and database.
Job Duties:
Process third party denials/appeals upon notification of an insurance denial, either by the Case Manager or the insurance company.
Manages third party appeals and denials in the Case Management and Meditech databases in order to provide accurate reporting at various hospital committees.
Completes data entry for all Denial and Appeal Management processes.
Maintains all correspondences and receipt acknowledgments to ensure receipt by payors.
Coordinates the telephonic and written appeal processes with Case Management staff, Physician advisors and payors.
Manages the Retro Appeal process for the department (RAC, MAC, QIC, Commerical payors, etc).
Assists in the build and maintenance of department databases as needed.
Prepares and analyzes reports using Excel and department software for department and committee reporting.
Works with Business Office to investigate and resolve outstanding utilization review/reimbursement issues.
Participates as a team member in establishing procedures relating to Case Management functions to promote efficient operations.
Demonstrates ability to prioritize work assignments in order to meet deadlines and maintain timely department operations.
Performs Case Management Technician's functions in her absence to ensure continuity in Case Management department.
Communicates denial trends to Case Management leadership.
Education and
Experience:
HS Diploma/GED and 1-3 years Business experience of health Care Billing experience.
Prefer knowledge of Billing, Case Management Coding, Pre-certification, contracts, financial account reconciliation and insurance Payor regulations (Commercial and Government)
Benefits:
Medical, Free Dental, Vision Insurance for full time and part time 403B Pension Plan On-site discounted Child Care Center Tuition Reimbursement up to $5250 per year Free Life Insurance Free Parking Paid Time Off Sick Time Flexible Spending Accounts Employee Referral Bonus Job Type:
Full-time Pay:
$19.
00 - $23.
00 per hour Expected hours:
40 per week
Benefits:
401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance Schedule:
Day shift Monday to Friday Work setting:
Hospital Education:
High school or equivalent (Required) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
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