Appeals Representative- Remote

2 weeks ago

Knoxville, Tennessee, United States TeamHealth Full time

TeamHealth has ranked three years running as "The World's Most Admired Companies" by Fortune Magazine and one of America's 100 Most Trustworthy Companies by Forbes Magazine in past years. TeamHealth, an established healthcare organization is physician-led and patient-focused. We continue to grow across the U.S. from our Clinicians to our Corporate Employees and we want you to join us.

This is a remote role

Benefits:

  • GENEROUS Personal Time Off
  • 8 Paid Holidays per year
  • Quarterly bonus plans- gives you the chance to add to your income
  • Learning and Development- from Patient Registration to Billing, internal subject matter experts offer ongoing training to get you up to speed.
  • Flexible work schedule

What You'll Love About TeamHealth:

  • Wellness programs- Our LiveWell program focuses on supporting you with all of your well-being needs so you can thrive Physically, Emotionally, Socially, and Financially
  • Work that Stays at Work. Your time off is yours
  • Health Benefits. Medical with HSA and FSA options, dental, vision, and life insurance.
  • Prepare for the Future. 401K program (Discretionary matching funds available)

JOB DESCRIPTION OVERVIEW:

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

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Reviews ETM task list assignment, comments, and rebills/appeals claim as necessary
  • Reviews denials to determine appropriate action based on carrier requirements
  • Posts appropriate rejection codes into system where applicable
  • Obtains status by establishing carrier contact if the submitted appeal has yielded no response
  • Identifies and forwards documentation to appeal disputed claims
  • Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues
  • Reviews carrier provider manuals for billing updates as needed
  • Reports any consistent errors found during review that affect claims from being processed correctly
  • Participates in department meetings with Accounts Receivable Team
  • Identifies trends in claims filed outside carrier timely filing deadlines and offers suggestions to prevent future occurrences
  • 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

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.

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