Appeals Coordinator

Full Time position in Utilization Management Department. Education, Experience and Training requirements include:

1.Minimum one year health information management experience in acute care setting highly preferred.

2.Accurate alphabetic, numeric, and/or terminal-digit filing skills.

3.Knowledge of terminal digit filing and medical terminology;? ? ?preferred.

4.Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred.

5.Computer data entry with 10-key, with accurate typing speed of 35 wpm; preferred.

6.High School Diploma or equivalent.

7.Completion of a medical terminology course; preferred.

8.Background in business and office training; preferred.

The appeals coordinator essentially works to coordinate the denials and appeals management process. Appeals coordinator is also responsible for coordinating all audit correspondence, conducting oversight of all RAC/audit functions, and following all RAC/audit activity to closure. Appeals coordinator will help prepare medical records for Government/Commercial payer audits, timely filing of appeal correspondence, track and follow up of denials while working closely with the Corporate RAC team/ Facility Appeals coordinator. The Appeals coordinator will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO and Medicaid/Commercial payers) as assigned. The Appeals coordinator will further support the department needs for Release of Information, or other duties as assigned.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Provider Appeal Coordinator
Essington, PA The Judge Group, Inc.
Associate Appeals Coordinator
Pittsburgh, PA ZOLL LifeVest
Ventricular Assist Device Coordinator VAD
Abington, PA Clinical Management Consultants
Clinical Coordinator
Mc Keesport, PA Davita
RN - Unit Coordinator - Registered Nurse
Pittsburgh, PA CommuniCare Health Services