- Collaborates and coordinates with all members of the health care team, patient and family (or significant others)
- Perform timely and accurate denial communications and activity; clarify communications as needed, and collect additional information in preparation for Nurse review
- Support the denial/appeal management nurse in collaborating with physicians, UM Nurses, PAS, and other members of the Interdisciplinary team, Revenue Cycle and payers to collect and relay all pertinent information to support successful appeals
- Document appeal activity according to department standards to support accurate reporting of denial and appeal status, outstanding revenue and to help identify trends
- Research and record appeals outcomes and produce reports related to denial and appeal outcomes
Requirements
- High School Equivalent / GED (Required) and Associate's Degree (Preferred)
- 2+ years of hospital or physician office billing or Utilization Management/Case Management department experience (Required)
- Experience in managed care (Preferred)
- Detail-oriented and organized, with good analytical and problem solving ability (Required proficiency)
- Notable client service, communication, presentation and relationship building skills (Required proficiency)
- Ability to function independently and as a team player in a fast-paced environment (Required proficiency)
- Strong written and verbal communication skills (Required proficiency)
- Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.) (Required proficiency)
- Strong typing skills (Required proficiency)
- Medical Terminology (Required proficiency)
Demonstrates expertise in denial and appeal management, with strong analytical skills to support accurate reporting and trend identification. Proficient in medical terminology and effective communication, fostering collaboration within interdisciplinary teams.
Highest-signal resume keywords
- Denial Management
- Appeal Management
- Utilization Management
- Medical Terminology
- Client Service
ATS Optimization Keywords
Hard Skills
- Billing Experience
- Analytical Skills
- Problem Solving
- Typing Skills
- Report Production
Soft Skills
- Detail-Oriented
- Organized
- Communication Skills
- Relationship Building
- Team Player
Certifications & Qualifications
- High School Equivalent / GED
- Associate's Degree
Industry Keywords
- Managed Care
- Interdisciplinary Team
- Revenue Cycle
- Patient Care
- Health Care Team
Tools & Technologies
- Microsoft Office Suite
- PC Proficiency
- General Office Equipment
Appeals Assistant Arbeitgeber: Jobtailor
Als Global Director B2B – Business Development bei uns profitieren Sie von einer dynamischen und innovativen Arbeitsumgebung, die auf Zusammenarbeit und Kreativität setzt. Wir bieten Ihnen nicht nur attraktive Vergütungsmodelle und umfassende Weiterbildungsmöglichkeiten, sondern auch die Chance, in einem internationalen Team zu arbeiten, das Vielfalt und persönliche Entwicklung fördert. Unsere Unternehmenskultur legt großen Wert auf Flexibilität und Work-Life-Balance, sodass Sie Ihre Karriereziele in einem unterstützenden Umfeld erreichen können.
