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Appeals Specialist

Kelly Services


Location:
Birmingham, TN
Date:
04/23/2018
2018-04-232018-05-22
Job Code:
US588WTT_BH1340702
Kelly Services
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Job Details

Job Title Appeals Specialist

Jobid US588WTT_BH1340702

Location: Birmingham, TN, USA

Description Appeals Specialist

Kelly Services Inc. is actively seeking an Appeals Specialist within the health care realm for our client located in the Birmingham Alabama area. This is a full time, direct hire opportunity with an etablished Medical Rehabilitaion Company of 47 yrs. The client offers a generous benefits package and fosters a family, friendly fun environment. Medical, Dental and Vision, 2 weeks paid vacation upon day one, paid holidays, Life Insurance, Disability, 401K company match.

Job Summary

Analyze and reviewing insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons related to the nonpayment of Insurance claims ï· Identify coding or clinical documentation issues and work to correct the errors in a timely manner. ï Identify problem accounts and escalates as appropriate ï· Update the patient account record to identify actions taken on the account. ï· Work with guarantors to secure payment on account balances outstanding for clinical reasons ï· Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” ï· Other duties as assigned

QUALIFICATIONS Education High school diploma or equivalent Experience 3+ years experience in Revenue Cycle, Medicare, Medicaid, and Commercial Insurance in a high-production environment. Working knowledge of Medicare, Medicaid, and Commercial insurance processes and Remittance Advices. Knowledge of CPT, ICD-9, ICD-10, and outpatient therapy billing preferred. Prefer experience with outpatient volumes in excess of 10,000 visits per week is preferred.

SKILLS Excellent oral and written communication skills Attention to detail, ability to multitask, organizational and detailed oriented, ability to meet deadlines, function independently, as a member of a team. Must possess efficient time management and presentation skills, and the ability to manage large volumes of data and be proactive in minimizing data quality defects. Working knowledge of Microsoft Excel, Word and ability to adapt to company s standard software programs. Working knowledge of Medicare, Medicaid, and Commercial insurance processes and Remittance Advices. Ability to examine processes, policies, and problems and offer solutions.

JOB FUNCTIONS Meet accounts receivable operational standards for productivity, quality, and customer-service standards Research and analyze patient accounts submitting appeals and contacting insurance companies as needed to overturn denials and incorrect payments Research, respond, and document insurance correspondence regarding coding, eligibility and benefits, and reimbursement on patient accounts Identify, analyze, and research frequent root causes of account reviews to coordinate corrective action plans for resolution of denials and identify opportunities for improvement Ability to effectively communicate with others within the business office, at the clinics as well as outside contacts patients, vendors, physicians, etc. Protects organization s value by keeping information confidential. Accomplishes accounting and organization mission by completing related results as needed. Maintain a working knowledge of insurance policies and procedures to ensure the timely resolution of claims issues Other duties as related and/or assigned


Experience:


+ 3+ years’ experience in Revenue Cycle, Medicare, Medicaid, and Commercial Insurance in a high-production environment.
+ Working knowledge of Medicare, Medicaid, and Commercial insurance processes and Remittance Advices. Knowledge of CPT, ICD-9, ICD-10, and outpatient therapy billing preferred.
+ Prefer experience with outpatient volumes in excess of 10,000 visits per week is preferred.
Requirements:


+ Communication - communicates clearly and concisely, verbally and in writing
+ Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
+ Interpersonal skills - able to work effectively with other employees
+ Attention to detail, ability to multitask, organizational and detailed oriented, ability to meet deadlines, function independently, as a member of a team.
+ Must possess efficient time management and presentation skills, and the ability to manage large volumes of data and be proactive in minimizing data quality defects.
+ Working knowledge of Microsoft Excel, Word and ability to adapt to company’s standard software programs
+ Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
Education:


+ High School Diploma/ Associates Degree preferred
**Why Kelly** **®** **?**


With Kelly, accounting and finance professionals like you will have access to some of the world’smost respected companies—providing you with challenging, high-visibility projects that can transformyour career. We work with 95 of the Fortune 100™ companies, and more than 3,000 finance and accountinghiring managers rely on us each year to access the best temporary and full-time talent: people likeyou.

Let us help advance your career today.

**AboutKelly Services** **®**

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 peoplearound the world and have a role in connecting thousands more with work through our global network oftalent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit kellyservices.com and connect with us on Facebook, LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and iscommitted to employing a diverse workforce. Equal Employment Opportunityis The Law.



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