Revenue Cycle Appeals Specialist
2 weeks ago
The Revenue Cycle Appeals Specialist plays a pivotal role in the management of medical appeals and audits, ensuring compliance with healthcare regulations and payer requirements. This position requires a comprehensive understanding of both inpatient and outpatient billing processes.
Key Responsibilities
- Review and analyze patient medical records to identify reasons for denials and determine appropriate appeal strategies.
- Collaborate with various departments, including Care Management and Compliance, to gather necessary information for appeals.
- Prepare and submit appeal letters, ensuring accuracy and completeness of information.
- Monitor and manage responses to audits from Medicare, Medicaid, and commercial payers.
- Maintain detailed documentation of all appeals, including outcomes and correspondence.
Qualifications
- An Associate degree in Health Information Technology or Nursing, with relevant certification.
- 2-5 years of experience in Utilization Management or Appeals Management.
- Strong written and verbal communication skills, with an emphasis on clarity and professionalism.
- Proficiency in Microsoft Office and electronic health record systems.
Work Environment
This position offers the flexibility of mobile or remote work arrangements, allowing for a balanced work-life dynamic. The ideal candidate will be detail-oriented, organized, and capable of working independently while contributing to the overall goals of the organization.
Benefits
- Comprehensive medical, dental, and vision coverage.
- Generous retirement savings plan with employer matching.
- Paid time off and holidays.
About Us
The University of Michigan is dedicated to improving the health of patients and communities through exceptional education, patient care, and research. Join our team and contribute to our mission of excellence in healthcare.
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