Appeals Assistant

Job Description

ESSENTIAL DUTIES AND RESPONSIBILITIES

? Track all appeals activity in collaboration with the Director of Denials and Appeals.

? Maintain all files as needed;

? Answer all hospital queries and provide guidance to appeals process.

? Assist appeals staff to track and meet appeals deadlines.

? Create reports of appeals activity and associated deadlines to determine opportunities to improve responses.

? Work with appeals department staff to identify opportunities to improve the physical workflow processes within the Denials and Appeals Department.

? This position will be Hybrid with occasional days in the office to submit appeals.

? Appeal submission will be through certified mail, fax and vendor electronic portals, depending on the individual payer.

? Other duties as assigned

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed

below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION/EXPERIENCE

Required

* High school diploma or equivalent
* Minimum of one year experience in a healthcare setting

KNOWLEDGE, SKILLS, AND ABILITIES

* Understanding of the revenue cycle and the responsibility and goals of each area and how they impact the revenue cycle
* Working knowledge of the revenue cycle
* Ability to communicate effectively both verbal and written
* Ability to work independently and to meet deadlines
* Working knowledge of current medical terminology
* Working knowledge of denials and appeal processes and the tracking software
* Ability to define problems, collect data, validate data, establish facts, and draw valid conclusions
* Working knowledge of Google Suite, Microsoft Word and Excel or equivalent