AR Denial Management and Appeals Specialist, 250 E Liberty, First Shift, Full Time, Potential for Remote
Job title: AR Denial Management and Appeals Specialist, 250 E Liberty, First Shift, Full Time, Potential for Remote in USA at UofL Health
Company: UofL Health
Job description: We are Hiring AR Denial Management and Appeals Specialist, 250 E Liberty, First Shift, Full Time, Potential for Remote at Med Plaza II - UMC!Primary Location: Med Plaza II - UMCAddress: 250 E Liberty Louisville, KY 40202Shift: Days 7A - 7P (United States of America)Job Description Summary:Job Description: The job summary for this position is not currently on file electronically. Please see your supervisorr or Human Resources Representative for a hard copy before you complete your acknowledgment.Additional Job Description:WE ARE HIRING!Location: 250 E. Liberty Street, Louisville, KY 40202Shift: FT, First ShiftAbout UofL Health:
UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital. Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to .Job Summary:Initiates the appeal process, at the direction of Revenue Cycle management, until the case is overturned, appeal options are exhausted, or decision is made to discontinue process. This position assumes the responsibility for coordinating and appealing technical denials and working closely with the HIM Appeals Specialist responsible for clinical appeals.
- Ability to review and determine reason for insurance denial of claims
- Review and appeal unpaid claims daily and submit appeal timely.
- Develop appeal letters to substantiate overturning denial, i.e. coverage, authorization, non-covered services, contract issue, timely filing limit, etc.
- Develop and maintain detail denial inventory list
- Tracks and trends progress and outcomes of denial and appeal processes and compiles reports for Revenue Cycle leadership
- Completes follow-up work on appealed claims.
- Works with insurance carriers on appeal issues.
- Ensure clinical appeals are submitted to the HIM department
- Monitor the payments to assure reimbursement from third-party payers is accurate based on payer contract.
- Reviews denials for accuracy.
- Stays abreast of payer updates for authorizations, eligibility, etc and communicates to Revenue Cycle leadership
- Documents all activity in Revenue Cycle system.
- Attends continue education programs
- Other duties as assigned.
- High School education or GED required.
- 1-3 years of prior billing, collection, or appeals
- Knowledge of medical terminology.
- Clear and concise written communication skills and development of professional letters.
- Basic Microsoft Office knowledge.
- Ability to foresee projects from start to finish.