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Billing Appeals Specialist - REMOTE

Company: PeaceHealth
Location: Vancouver
Posted on: November 25, 2022

Job Description:

**Description**



Hospital Appeals for a Full Time, Remote, 1.00 FTE, Day position. Hourly compensation starts at $17.61, more depending on experience.



**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:**



+ 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



+ Ability to read and understand insurance EOB's and to understand payor contracts.



+ Proven ability to communicate effectively with payors and provider offices, either by written or spoken means.



+ Proficient use of computers including Microsoft Office 2010 applications



+ Ability to work with minimal supervision, independently, as well as in a collaborative team setting



+ Strong organizational skills with the ability to prioritize and meet deadlines



+ Knowledge of Commercial and/or Government Payors



+ Ability to lift objects weighing 30 lbs. or less.



For a full description of the position, or for questions, please email KShepherd@peacehealth.org



See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (https://www.thecaregiver.org/wp-content/uploads/2017/05/PeaceHealth-Statement-of-Commitment-to-Diversity-and-Inclusion-vFINAL.pdf) .



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.



REQNUMBER: 46203

Keywords: PeaceHealth, Vancouver , Billing Appeals Specialist - REMOTE, Accounting, Auditing , Vancouver, Washington

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