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Appeals Support Specialist

Job ID: 12096
Location: Vancouver, WA
Work Type: Full Time
Shift: Day
Shift Length: 8 Hours
FTE: 1.00
Benefit Eligibility: Full-time benefits

Job Description

Description

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.​

PeaceHealth is seeking a Appeals Support Specialist for a Full Time, Day position.  

JOB SUMMARY
Appeals Support Specialist will handle the compilation, imaging and submitting of appeals, as well as making calls to payors requesting denial letters and assisting with the documentation of recoveries and outstanding denials.

ESSENTIAL FUNCTIONS

  1. Compiles all documents, letters, medical records, images, etc as needed for submitting appeals to payors.
  2. Mails, faxes or otherwise sends appeal packets to payors.
  3. Images appeal packets
  4. Follows up with payors to obtain denial letters or to check on status of submitted appeals
  5. Produces reports of received denials, noting disposition and recoveries
  6. Conducts research as needed regarding denials and appeals
  7. Maintains Appeal Team recovery logs
  8. Maintains master payor list
  9. Prepares Appeal Team Meeting agendas and minutes
  10. Performs other duties as assigned.

QUALIFICATIONS (required unless otherwise designated.)

EDUCATION: 
  • High School Diploma or equivalent preferred

EXPERIENCE/TRAINING:
  • Minimum of two years’ experience in an accounting, banking, medical office, billing or insurance account follow-up capacity is required; Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered.
  • Medical terminology experience preferred.
  • Knowledge of insurance processes and billing guidelines regulations preferred.

OTHER SKILLS:
  • Proficient in Windows based PC applications (including Word, Excel, PowerPoint, and Outlook).
  • Excellent verbal and written communication skills.
  • Strong organizational and analytical skills.
  • Ability to manage multiple priorities, projects and display flexibility in a fast paced and changing work environment.
  • Ability to work with office equipment. 

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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