Vacancy caducado!
OverviewInsurance Appeals Associate Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Summary: This position has the responsibility of working patient accounts as defined by the department established policies and procedures under the Manager and Supervisor within the department. It requires knowledge of insurance payment rules and regulations. It may require managing multiple work assignments at the same time. Specifics and volume of work is defined by the functional area within the Revenue Integrity Department. All work shall be completed in a timely and accurate manner. Recruiter: Kathleen Rice [email protected] 865-374-5386 Responsibilities
Analyze denials and coordinates insurance appeals.
Recognizes situations which necessitate supervision and guidance, seeks appropriate resources.
Ensures team members are compliant with front end and back end appeals hand-offs, maintaining payer correspondence and claims processing.
Notifies Appeals Supervisor or Revenue Integrity Manager when trends are identified while processing claim denial correspondence and follow-up of appeals.
Documents all activities in denials management and financial systems to ensure timely handoffs.
Demonstrates the ability to understand billing regulations and payer requirements.
Able to handle varying tasks as well as understanding patient accounting processes relative to the revenue process to ensure appropriate reimbursement is received.
Communicates effectively with patients/public, co-workers, physicians, facilities, agencies and/or their offices and other facility personnel using verbal, nonverbal, and written communication skills.
Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
QualificationsMinimum Education: N one specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Minimum Experience: Two (2) years of experience in hospital billing or insurance pre-certification required; Must be familiar with healthcare billing and insurance regulations such as those required by Medicare, Medicaid or Commercial payers. Computer experience is required. Licensure Requirements: None. Apply/ShareJob Title INSURANCE APPEALS ASSOC ID 3954286 Facility Covenant Health Corporate Department Name REV INTEGRITY & UTIL
Vacancy caducado!