Appeals Representative (REMOTE)
Company: TeamHealth
Location: Akron
Posted on: April 26, 2024
Job Description:
TeamHealth is named among the "150 Great Places to Work in
Healthcare" by Becker's Hospital Review and has ranked three years
running as "The World's Most Admired Companies" by FORTUNE Magazine
as well as one of America's 100 Must Trustworthy Companies by
Forbes Magazine in past years. TeamHealth, an established
healthcare organizations is physician-led and patient-focused. We
continue to grow across the U.S. from our Clinicians to our
Corporate Employees and we want you to join us.
- Career Growth Opportunities
- Benefit Eligibility (Medical/Dental/Vision/Life) the first of
the month following 30 days of employment
- 401K program (Discretionary matching funds available)
- GENEROUS Personal time off
- Eight Paid Holidays per year
- Quarterly incentive plans*The Akron, OH billing center has
multiple openings for Appeals Representatives. These are remote,
work-from-home positions* JOB DESCRIPTION OVERVIEW:
- The Denials & Appeals Representative will review, organize, and
monitor incoming payment denials, taking appropriate corrective
action. The Analyst responds to carrier issues as needed and
processes all appeals including Medicare, Medicaid, Blue Shield,
and Commercial carriers.ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Monitor and review all payment denials as assigned in
Enterprise Task Manager and process these claims in the time frame
assigned within the system
- Utilize the telephone and various carrier websites as research
tools to expedite resolution for issues
- Assembles and forwards documentation to appeal disputed claims
through Waystar
- Assist with research and development of appropriate denial
procedures
- Contacts carriers to inquire on claims that have been denied
and appealed
- Assembles and forwards appropriate documentation to the Senior
Analyst for provider related issues
- Review carrier manuals and websites and informs management of
any new procedures implemented by the carrier that are impacting
our claims
- Reports any consistent errors found during claims review that
may affect claims from being processed correctly
- Consistently meet established completion times for projects and
assignments
- Consistently meet and maintain the QA (95% or better) and
designated production standards per sub-team QUALIFICATIONS /
EXPERIENCE:
- High school diploma or equivalent required
- Previous medical billing experience preferred with primary
emphasis on denial research and appeal processing
- Knowledge of Physician Billing Policies and Procedures across
multiple states
- Excellent communication skills both oral and written
- Good computer skills with proficiency in Microsoft Outlook,
Excel, Word, GE Centricity Business/ETM
- Ability to meet deadlines and work independently
- Ability to work overtime as neededDISCLAIMER: Cooperative,
positive, courteous and professional behavior and conduct is an
essential function of every position. All employees must be able to
work with others beyond giving and receiving instructions. This
includes getting along with co-workers, peers and management
without exhibiting behavior extremes. Job functions may require
personal leadership skills such as conflict resolution,
negotiating, instructing, persuading, speaking with others as well
as responding appropriately to job performance feedback from the
supervisor. Additionally, the information contained in this job
description has been designated to indicate the general nature and
level of work performed by employees within this classification. It
is not designed to contain or be interpreted as a comprehensive
inventory of all duties, responsibilities and qualifications
required of employees assigned to this position.
Keywords: TeamHealth, Akron , Appeals Representative (REMOTE), Other , Akron, Ohio
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