AR Denials Management and Appeals Specialist- Part-Time - UofL Health

We are Hiring.

Location: 250 E. Liberty Street Louisville, KY 40202

Shift: Part-Time Days

About Us

UofL Health is a fully integrated regional academic health system with seven hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehabilitation Institute and the Brown Cancer Center.

With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.

Our Mission

As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.

Job Summary

Initiates the appeal process, at the direction of Revenue Cycle management, until the case is overturned, appeal options are exhausted, or decision is made to discontinue process.  This position assumes the responsibility for coordinating and appealing technical denials and working closely with the HIM Appeals Specialist responsible for clinical appeals. 

• Ability to review and determine reason for insurance denial of claims
• Review and appeal unpaid claims daily and submit appeal timely.
• Develop appeal letters to substantiate overturning denial, i.e. coverage, authorization, non-covered services, contract issue, timely filing limit, etc.
• Develop and maintain detail denial inventory list
• Tracks and trends progress and outcomes of denial and appeal processes and compiles reports for Revenue Cycle leadership
• Completes follow-up work on appealed claims.
• Works with insurance carriers on appeal issues.
• Ensure clinical appeals are submitted to the HIM department
• Monitor the payments to assure reimbursement from third-party payers is accurate based on payer contract.
• Reviews denials for accuracy.
• Stays abreast of payer updates for authorizations, eligibility, etc and communicates to Revenue Cycle leadership
• Documents all activity in Revenue Cycle system.
• Attends continue education programs
• Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• High School education or GED required.
• 1-3 years of prior billing, collection, or appeals

KNOWLEDGE, SKILLS, & ABILITIES

• Knowledge of medical terminology.
• Clear and concise written communication skills and development of professional letters.
• Basic Microsoft Office knowledge.
• Ability to foresee projects from start to finish.

Benefits & Perks
• Competitive Pay & Benefits Options
• Paid Vacation, Sick days, and Holidays
• Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner
• 401K with Employer Match

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