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Posted: Friday, May 12, 2017 7:16 PM

Job Summary – The Appeals Specialist is responsible for performing end to end tasks for technical appeals.
Duties (included but not limited to):
  • Triage incoming inventory for the Appeals team, validating appeal criteria is met
  • Compose technical denial arguments for reconsideration, including both written and telephonically
  • Identify contract protection that can be leveraged to overturn denials.
  • Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument
  • Identify problem accounts/processes/trends and escalate as appropriate
  • Utilize effective documentation standards that support a strong historical record of actions taken on the account.
  • Ability to perform basic math to ensure accurate statement of accounts receivable
  • Meet the productivity and quality standards of the organization
  • Timely completion and comprehension of all educational requirements
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
  • Other duties as assigned

Click here for more info: https://hca.taleo.net/careersection/0hca/jobdetail.ftl?job=08948-132163&lang=en


• Location: Houston

• Post ID: 51692038 houston
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