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PFS Appeals Coordinator
4 months ago
Coordinates complex appeals for denied claims and retro authorization appeals. Coordinates with third party vendors for additional appeal support. Provides appeals support for status of accounts that have been appealed with payors. This job requires the application and interpretation of policies and procedures and the use of independent judgment in a medical setting. The purpose is to achieve the revenue cycle goals for the medical center and to ensure minimum loss of revenue and maximum payment for services rendered. The ability to maintain a working knowledge of carrier contracts/changes, clinical policy/procedures and departmental policies and procedures is required. The position requires the ability to effectively communicate the root cause of the denials back to departments in order to prevent future losses.
* Analyzes information required to complete appeals with insurance carriers, service area contacts and workman's compensation carriers.
* Demonstrates skill in the proficient use of UVA software systems to ensure appeal and/or retro-authorization information is entered into required computer systems and to the payors in an accurate and timely manner.
* Demonstrates the skills of effective communication, decision-making and organization to ensure efficient job performance and job success.
* Demonstrates ability to adhere to policies and procedures.
Position Compensation Range: $22.39 - $35.82 Hourly
MINIMUM REQUIREMENTS
Education: Associate degree required.
Experience: 5 years of Revenue Cycle experience in lieu of Associates Degree, or Bachelor and 3 years of Revenue Cycle Experience required.
Licensure: Coding Certificate preferred (Coding Certification must be obtained within 12 months of hire).
PHYSICAL DEMANDS
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs.
The University of Virginia, including the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician's Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.
