What are the responsibilities and job description for the Appeals Coordinator position at University Physicians' Association?
Description
University Physicians' Association, Inc. is looking for a full time Appeals Coordinator at our Central Billing Office.
JOB DUTIES:
This description is a general statement of required major duties and responsibilities performed on a regular and continuous basis. It does not exclude other duties as assigned.
- Knowledgeable of insurance guidelines and requirements for appeal submission.
- Resolve denials or partially paid claims by completing and submitting appeals according to payer specific guidelines.
- Ability to review & explain complex medical coding situations and/or supporting medical documentation in written and verbal communication to effectively complete an insurance appeal.
- Identify denial/appeal trends and notify manager of trends.
- Track and generate reports of appeal outcomes.
- Update payer escalation spreadsheets and facilitate communications with payer representatives regarding those spreadsheets.
- Ability to work as a team player.
- Correspond with Accounts Receivable Representatives, Team Supervisors, and other leadership to educate on common appeal errors and to resolve inquiries or questions regarding appeals in a timely and professional manner.
Requirements
Requires High School education or equivalency; medical billing courses and/or college preferred.
QUALIFICATIONS:
1. Medical billing office experience preferred.
2. Must be able to operate all required job related equipment to include but not limited to computer, computer programs, fax, phone and copier.
3. Strong ability to work with Microsoft Office products.
4. Working knowledge of ICD-10 and CPT codes and third-party operating procedures and practices.
5. Familiar with medical terminology & medical documentation review.
6. Must be well organized and detail oriented.
7. Must have strong written and verbal communication skills.
8. Ability to read, understand written and oral instructions.
9. Ability to work as a team player.
PHYSICAL DEMANDS:
Requires sitting for long periods of time with the occasional standing associated with a normal office environment. Must be able to operate all required job related equipment to include but not limited to computer, fax, phone and copier. Will require the occasional reaching, bending, stooping, kneeling or crouching. This description is intended to provide only basic guidelines for meeting job requirements. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.
