As anAppeals Specialist II at Community Health Systems, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including health insurance, flexible scheduling, 401k and student loan repayment programs.
Required:
- Experience: A minimum of year related experience
- Education: H.S. Diploma
- Computer Skills: To perform this job successfully, an individual should have knowledge of Word Processing software, Spreadsheet software and E-mail software
Preferred:
- Education: Associate’s Degree (A.A.) or Bachelor’s degree (B.S. or B.A.)
Essential Functions
- Manages workflow for all incoming appeal determination letters & audit correspondence via centralized email and isynergy folders
- Accurately vets accounts; meets or exceeds quality & quantity benchmark targets as established (productivity/PDFU)
- Directs Cerner/ClaimIQ/BARRT requests to appropriate parties (including CAU 2nd level referrals) for appeal review & validation.
- Completes Cerner/ClaimIQ/Artiva requests within 72hours and documents appropriately
- Manages PDFU to assure timely follow-up of accounts to effectively move through the revenue cycle
- Accurately enters data into the Appeal Tracker, Cerner/ClaimIQ/Artiva, or other programs
- Submits requests for medical records, ub’s, and itemized bills as needed
- Ability to perform all other duties as assigned or requested
- Ensure confidentiality of all patient accounts by following HIPAA guidelines
- This is a remote position.
