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Healthcare Appeals Analyst

The CSI Companies

This is a Contract position in Nashville-Davidson, TN posted May 23, 2019.

CSI Professional is actively seeking a?

Healthcare Appeals Analyst?for a position with our client located in the Nashville, TN area .?As a top Fortune 500 company, our client has been named one of the?

World’s Most Ethical Companies nine years in a row.??

This is an exciting opportunity to join a leading provider of healthcare business and operational services team Weekly pay provided and health, dental and vision insurance offered Hours: Monday
– Friday (normal business hours) Pay rate: $16-19/hr (based on experience) Location: Nashville, TN 37211 OVERVIEW: The Healthcare Appeals Analyst?is responsible for performing end to end tasks for technical appeals.

Duties and Responsibilities 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 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 Skills Required: Communication
– communicates clearly and concisely, verbally and in writing.?

This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.

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, patients and external parties PC skills
– demonstrates proficiency in Microsoft Office applications and others as required Policies & Procedures
– demonstrates knowledge and understanding of organizational policies, procedures and systems Technical skills
– Professional presentation skills needed to represent facilities in legal issues.

Basic skills
– able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately Clinical skills ?

ability to read and interpret medical records a plus Maintain acceptable working knowledge of denials and appeal processes including a basic understanding of contracts and payer policies Maintain working knowledge of current medical terminology Understanding of the revenue cycle and the responsibility and goals of each area and how they impact the revenue cycle Education, Skills & Experience: High school diploma or GED required Minimum of two years?experience in a healthcare setting Working with managed care claims and appeals Working knowledge of the revenue cycle Detail oriented, analytical and ability to problem solve Working knowledge of Outlook, Microsoft Word and Excel or equivalent