Appeals Coordinator

Prime Healthcare • Ontario, CA

1d • Onsite

About The Position

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0 million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Requirements

• High School Diploma or equivalent.
• Good communication skills is required.

Nice To Haves

• Minimum one-year health information management experience in acute care setting highly preferred.
• Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred.
• Computer data entry with 10-key, with accurate typing speed of 35 wpm; preferred.
• Completion of a medical terminology course; preferred.
• Background in business office or office training in the healthcare field; preferred.

Responsibilities

• Assists mailing personnel in achieving timely, accurate, and complete appeals mailing process.
• Tracks all appeals and denials through the denials database.
• Creates records for new appeal requests, prepares electronic files, and files patient data upon receipt.
• Prioritizes work load to ensure that appeals are submitted timely.
• Follows-up with HIM personnel to obtain records when required documentation is missing.
• Ensures that once the required documentation is provided by HIM staff, it will be attached with appeal letter packet and mailed out.
• Responsible for answering update requests from Business Office personnel either via phone or emails.
• Supports the department needs providing feedback to management regarding trends or patterns, actively participating in departmental meetings, offering suggestions for improvement of processes as well as being receptive to suggestions.
• Assists with monthly and quarterly reports as needed.
• Serves as the primary contact coordinating and maintaining the integrity of tracking commercial appeals and following other duties as assigned.

Benefits

• paid time off
• a 401K retirement plan
• medical, dental, and vision coverage
• tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED