Appeals Rep Great company in Louisville, Tennessee hasb an immediate opening for a Appeals Rep Contract with potential to hire Monday-Friday from 8am-4:30pm
- Reviews ETM task list assignment, comments, and rebills/appeals claim as necessary
- Reviews denials to determine appropriate action based on carrier requirements
- Posts appropriate rejection codes into system where applicable
- Obtains status by establishing carrier contact if the submitted appeal has yielded no response
- Identifies and forwards documentation to appeal disputed claims
- Assembles and forwards appropriate documentation to the senior representative for provider and carrier related issues
- Reviews carrier provider manuals for billing updates as needed
- Reports any consistent errors found during review that affect claims from being processed correctly
- Participates in department meetings with Accounts Receivable Team Identifies trends in claims filed outside carrier timely filing deadlines and offers suggestions to prevent future occurrences
- Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc
- Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager