AR Denials Management and Appeals Specialist 250 E Liberty St
AR Denials Management and Appeals Specialist 250 E Liberty St
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
WE ARE HIRING!
Location: 250 E. Liberty Street Louisville KY 40202
Shift: FT First Shift
About UofL Health:
UofL Health is a fully integrated regional academic health system with nine hospitals four medical centers Brown Cancer Center Eye Institute nearly 200 physician practice locations and more than 1000 providers in Louisville and the surrounding counties including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital. Affiliated with the University of Louisville School of Medicine UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials collaboration on research and the development of new technologies to both save and improve lives. With more than 13000 team members physicians surgeons nurses pharmacists and other highlyskilled health care professionals UofL Health is focused on one mission: to transform the health of communities we serve through compassionate innovative patientcentered care. For more information on UofL Health go to www.uoflhealth.
Job Summary:
Initiates the appeal process at the direction of Revenue Cycle management until the case is overturned appeal options are exhausted or decision is made to discontinue process. This position assumes the responsibility for coordinating and appealing technical denials and working closely with the HIM Appeals Specialist responsible for clinical appeals.
Responsibilities
- Ability to review and determine reason for insurance denial of claims
- Review and appeal unpaid claims daily and submit appeal timely.
- Develop appeal letters to substantiate overturning denial i.e. coverage authorization noncovered services contract issue timely filing limit etc.
- Develop and maintain detail denial inventory list
- Tracks and trends progress and outcomes of denial and appeal processes and compiles reports for Revenue Cycle leadership
- Completes followup work on appealed claims.
- Works with insurance carriers on appeal issues.
- Ensure clinical appeals are submitted to the HIM department
- Monitor the payments to assure reimbursement from thirdparty payers is accurate based on payer contract.
- Reviews denials for accuracy.
- Stays abreast of payer updates for authorizations eligibility etc and communicates to Revenue Cycle leadership
- Documents all activity in Revenue Cycle system.
- Attends continue education programs
- Other duties as assigned.
Qualifications
MINIMUM EDUCATION & EXPERIENCE
- High School education or GED required.
- 13 years of prior billing collection or appeals
KNOWLEDGE SKILLS & ABILITIES
- Knowledge of medical terminology.
- Clear and concise written communication skills and development of professional letters.
- Basic Microsoft Office knowledge.
- Ability to foresee projects from start to finish.
Required Experience:
Unclear Seniority
Employment Type
Unclear
