Job Opening: Appeals Rep

Appeals Rep

Great company in Louisville, Tennessee hasb an immediate opening for a Appeals Rep

Contract with potential to hire 

Monday-Friday from 8am-4:30pm

• Reviews ETM task list assignment, comments, and rebills/appeals claim as necessary
• Reviews denials to determine appropriate action based on carrier requirements
• Posts appropriate rejection codes into system where applicable
• Obtains status by establishing carrier contact if the submitted appeal has yielded no response
• Identifies and forwards documentation to appeal disputed claims 
• Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues 
• Reviews carrier provider manuals for billing updates as needed 
• Reports any consistent errors found during review that affect claims from being processed correctly
• Participates in department meetings with Accounts Receivable Team Identifies trends in claims filed outside carrier timely filing deadlines and offers suggestions to prevent future occurrences
• Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc
• Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager