Audits and Appeals Analyst

4 weeks ago


Santa Ana, United States St. Edna Subacute & Rehab Center Full time

THIS OPENING IS FOR OUR RESOURCE CENTER IN ALISO VIEJO. Please only apply if you are able and willing to work from our Aliso Viejo location. Thank you#hpstedna

Position: Audits and Appeals Analyst

Description: Covenant Care is a Resource Center supporting 30+ Skilled Nursing Facilities, Assisted Living Communities, and a Home Health Division from its corporate offices in beautiful Aliso Viejo, California.

Schedule: This is an in-office position: Monday - Friday at Aliso Viejo offices to monitor mail boxes, compile (print, fax, mail) appeal packets and interact with other staff members.

Education and Experience:

  • High School Degree required, (Associates or Bachelors preferred)
  • Minimum of 3 years experience in a skilled nursing facility or similar environment
Primary Responsibilities Include:
  • Oversees multiple Payer Portals acting as Resource for facility Business Office Managers
  • Initiates tracking process after receipt of Medical Documentation Requests
  • Verify contract language vs. payment to determine reason for incorrect payment
  • Use strategic thinking skills to determine, analyze/write appeal letters to health plans
  • Contacts various payer sources to clarify underpayments and/or denial reasons
  • Maintains ongoing communication with facilities prompting them on claims submissions
If you meet the requirements above please send resume for review and consideration.

We are a great company to work for and provide a safe and comfortable work environment.

Other benefits include:
  • Company sponsored Health Benefits: Medical - PPO, HSA and Kaiser Plan Options available
  • Dental - Ameritas high and low options
  • Vision Reimbursement Plan
  • Company PAID Life and Disability Insurance (with options for "buy up)
  • 401(k) savings plan
  • Paid Time Off (Vacation, Sick, Holiday)
  • Company PAID Employee Assistance program (EAP)
  • Voluntary Supplemental Health Protection Plans
  • Employee sponsored discount programs and more....


We are proud to be an equal opportunity employer.

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