Appeals Specialist
About this role
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career opportunity? Have you recently been seeking out prestigious, national healthcare companies with which to further your longterm goals? Are you seeking REAL advancement opportunities in-house with a Fortune 500 company? If you answered “yes" to any of these questions – then this opportunity may be for you!
Daily Responsibilities:
In this role, you will be responsible for validating disputes presented on EOBs, entering denied claims into company database & escalating paymment/variance trends to management
Responsibilities:
Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons
Coordinates for clinical consultations or account referrals when necessary
Generate an appeal based on the dispute reason and contract terms specific to payer
Follow specific payer guidelines for appeals submission
Escalate exhausted appeal efforts for resolution
Review denial reasons on EOBs to determine denials
Enter denied claims into database
Work payer projects as directed
Identify denial & variance trends
Shift: Monday - Friday / 8:00 am – 4:30 pm
Advantages of this Opportunity:
Competitive hourly pay above regional average!
Longterm stability and individual professional growth potential from a national Healthcare company that continues to grow!
Daytime, weekday schedule.
You will have the opportunity to add great experience to your resume, while getting the chance to network with several future colleagues in a highly-competitive insurance claims field.
Qualifications
What We Look For:
1-2 years in a healthcare administrative environment performing billing and/or collections
3-5 years of A/R follow up with insurance on claims (direct contract with insurancess
Full understanding of the insurance denials / appeals process
Excellent computer skills with emphasis on use of Excel spreadsheets
High School Diploma or GED
Additional Information
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