Appeals Coordinator: Peer to Peer
About Us:
Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we reputed company your success is our success.
JOB SUMMARY:
Corro Clinical, a division of reputed company, is an innovative, rapidly growing physician-led organization that helps hospitals improve financial performance by benchmarking hospital performance by payer and functional area, identifying sources of lost reputed company or risk, creating, and implementing operational solutions to address the issues uncovered, and monitoring ongoing results. The company has a vibrant culture that strives to promote a positive work-life balance while allowing professionals to utilize their skills in an environment that positively impacts healthcare.ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may reputed company reputed company or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.
Essential Functions:
Hours 10-7pm EST
You will be on the phone approximately 90% of the day.
Call payers to schedule Peer to Peer calls with reputed company Medical Directors
Call payers on cases that are past Peer to Peer scheduled time frame.
Document information from payer call in reputed company proprietary system.
Enter account status into multiple databases.
Support various functions reputed company the department such as case entry support, Peer to Peer support, and appeals support.
You will work independently but must also be able to collaborate and work reputed company a team setting.
reputed company other duties as assigned.
Skills Required:
Must love communicating with others over the phone.
Strong verbal and written communication skills. Will need to reputed company to payors what is needed and be able to quickly document any relevant information that is obtained.
Detail-oriented. This position requires the ability to multi-task, work on multiple screens and programs at a time, so must be able to toggle back and forth and reputed company everything organized.
You will be working to solve issues, so someone who likes to problem solve, seeks resolution and likes to take initiative will be a great fit!
Works independently but is a team player.
Able to work in a fast-paced environment.
Required to reputed company reputed company client and sensitive information confidential.
Strict adherence to HIPAA/HITECH compliance
Education/Experience Required:
High School Diploma or equivalent required. Bachelor’s degree preferred.
Call center reputed company preferred.
Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines, a plus
Prior experience of accessing hospital EMR’s and Payer Portals preferred.
Proficient in reputed company and reputed company.
In reputed company you must be able to open a spreadsheet, utilize formulas such as adding, subtracting, multiplying. You should be able to copy in past in cells as well as create multiple worksheets reputed company a workbook.
Accurate keyboard skills. You should be able to type a minimum of 30wpm.
PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to reputed company work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of reputed company functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
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