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Job Requirements of Appeals Representative:
QUALIFICATIONS / EXPERIENCE:- High school diploma or equivalent required.
- Two-years previous medical billing experience preferred with emphasis on research and claim denials in Accounts Receivable preferred.
- Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, appeals process and physician billing preferred.
- Proficient in Microsoft Office.
- Must possess excellent oral and written communication skills.
- Must be well-organized and possess ability to follow-up on claims.
- Must be self-motivated.
- None
PHYSICAL / ENVIRONMENTAL DEMANDS:
- Job performed in a well-lighted, modern office setting
- Occasional standing/bending
- Occasional lifting/carrying (20lbs or less)
- Moderate stress
- Prolonged sitting
- Prolonged work on a PC/computer
- Prolonged telephone work
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer
Do you meet the requirements for this job?
Appeals Representative
TeamHealth
Alcoa, TN (Onsite)
Full-Time
JOB DESCRIPTION OVERVIEW:
Position is responsible for reviewing assigned denials to ensure claims are being processed correctly and efficiently.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Position is responsible for reviewing assigned denials to ensure claims are being processed correctly and efficiently.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Reviews assigned denials to determine appropriate action based on payer requirements.
- Assembles and prepares required documentation for appeal in billing system to appeal disputed claims.
- Assembles and forwards required documentation for payer guidelines.
- Maintains working knowledge of carrier requirements for claim appeals and claim appeal billing systems.
- Identifies and report consistent errors that impact claims from being processed correctly.
- Performs additional duties and assignments as requested.
Job Requirements:
QUALIFICATIONS / EXPERIENCE:
PHYSICAL / ENVIRONMENTAL DEMANDS:
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer
- High school diploma or equivalent required.
- Two-years previous medical billing experience preferred with emphasis on research and claim denials in Accounts Receivable preferred.
- Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, appeals process and physician billing preferred.
- Proficient in Microsoft Office.
- Must possess excellent oral and written communication skills.
- Must be well-organized and possess ability to follow-up on claims.
- Must be self-motivated.
- None
PHYSICAL / ENVIRONMENTAL DEMANDS:
- Job performed in a well-lighted, modern office setting
- Occasional standing/bending
- Occasional lifting/carrying (20lbs or less)
- Moderate stress
- Prolonged sitting
- Prolonged work on a PC/computer
- Prolonged telephone work
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer
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