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Billing Appeals Specialist - REMOTE

Job ID: 45643
Location: Vancouver, WA
Work Type: Full Time
Shift: Day
Shift Length: 8 Hours
FTE: 1.00
Benefit Eligibility: Full-time benefits

Job Description


PeaceHealth is seeking a Billing Appeals Specialist - Hospital Appeals for a Full Time, 1.00 FTE, Day position. Hourly compensation is $18.30 - $27.46; hiring rate dependent on qualifications and professional experience.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

This position will be performed fully remote. If telecommuting, PeaceHealth will provide the caregiver with necessary computer equipment. It is the responsibility of the caregiver to provide Internet access.

Must reside in Washington, Oregon, Texas or Alaska.

Responsible for the resolution of appeals relating to technical issues identified during the billing of claims and the follow-up on the clinical appeals performed by the clinical auditor. Ensures acceptable reimbursement and appropriate days in Accounts Receivable by initiating, processing, and resolving all appeals

Details of the position:

  • Drafts appeals to insurance companies for reimbursement of monies owed and initiates formal appeals.
  • Processes and maintains correspondence received from patients and insurance companies as they pertain to logging, tracking, and processing technical denials.
  • Conducts pertinent research in order to evaluate, respond to, and close appeals.
  • Identifies more complex appeals issues and reports to clinical auditor and Appeals Team Manager.
  • Communicates appeal issues with payors/providers to aid in resolution of denials.
  • Produces reports of received denials, noting disposition and recoveries
  • Ensures compliance with organizational and regulatory guidelines. Ensures compliancy is met and processes claims in accordance with contracts and policies. Adjudicates claims as appropriate.

What you bring:

  • Medical Billing Certificate is preferred
  • Minimum of two years’ experience in a billing or insurance account follow-up capacity is required; Formal training or college coursework from an accredited medical coding school, specific to medical billing in lieu of experience may be considered
  • Medical terminology experience required
  • Knowledge of insurance processes and billing guidelines regulations required
  • Coding knowledge preferred
  • Epic experience, specifically Resolute Billing Module experience preferred
  • Proficient use of computers including Microsoft Office 2010 applications
  • Ability to lift objects weighing 30 lbs. or less.
  • Work is performed under normal working conditions with adequate lighting and ventilation.
  • Job duties frequently require intense concentration and attention to detail (up to 65% of work time).

For a full description of the position, or for questions, please email [email protected]

Must be fully vaccinated for COVID-19 including 2 doses of a 2-dose series or 1 dose of a 1-dose series plus 14 days beyond the final dose prior to start date.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

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