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Denials Resolution & Appeals Representative in Louisville, Tennessee, US at TeamHealth

Date Posted: 9/28/2020

Job Snapshot

Job Description

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

  • Career Growth Opportunities
  • Convenience market on site
  • Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
  • 401K program (Discretionary matching funds available)
  • Employee Assistance Program
  • Referral Program
  • Dental plans & Vision plans
  • GENEROUS Personal time off
  • Eight Paid Holidays per year
  • Quarterly incentive plans
  • Business casual dress code
  • Free Parking
  • Free coffee daily
  • Employee of the month awards with monetary gift and parking space
  • Training Programs
  • Fitness Center with personal trainer on site
  • Awesome Facility with terrific amenities
  • Wellness programs
  • Flexible work schedule

JOB DESCRIPTION OVERVIEW:

This position is responsible for reviewing various carrier denials at their assigned Billing Group.  Maintains accuracy and production to ensure invoices are being processed efficiently.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Reviews ETM tasklist assignment, comments, and rebills claim as necessary.
  • Reviews denials to determine appropriate action based on carrier requirements.
  • Identifies and forwards documentation to appeal disputed claims.
  • Assembles and forwards appropriate documentation to the senior representative for provider related issues.
  • Reviews carrier provider manuals and updates.
  • Reports any consistent errors found during review that affect claims from being processed correctly.
  • Participates in department meetings with Accounts Receivable Team.
  • Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc.
  • Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager.

 

Job Requirements

EXPERIENCE / SKILLS: 

  • One year medical billing experience
  • Knowledge of physician billing policies and procedures
  • Computer literate
  • Ability to work in a fast-paced environment
  • Excellent organizational skills
  • Ability to work independently

EDUCATION:

  • High school diploma or equivalent.

WORKING CONDITIONS:

  • This job will be performed in a well-lighted and well-vented environment. Requires constant sitting tolerance. Involves extensive computer use.
  • Set in a pleasant, high-volume, fast-paced office environment.
  • Overtime may be required and can be mandated by Management.

DISCLAIMER:

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 Manager. 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.