Coordinator, Appeals Management

CorroHealth

About The Position

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 believe your success is our success. JOB SUMMARY: Appeals Management for Prior Authorization Group. 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 perform all 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.

Requirements

Must love communicating with others over the phone
Computer proficient. Must have intermediate skills with Outlook and Excel. Must be able to schedule meetings, log onto Teams for meetings. Must be able to open a new excel workbook, use formulas such as; adding and subtracting, copying and pasting.
Must be able to type a minimum of 25wpm
Detail oriented
Shows initiative and responsibility in taking the necessary steps towards problem resolution
Works independently, but is a team player
Able to work in a fast-paced environment
Possess good verbal and written communication skills
Required to keep all client and sensitive information confidential
Strict adherence to HIPAA/HITECH compliance
High School Diploma or equivalent required
Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines
Proficient in MS Word and Excel. Needs to be able to open a new excel workbook, copy and paste, do basic formulas such as adding, subtracting and copying and pasting. Must have basic skils in Outlook. Should be able to create a meeting invitation, accept a meeting invitation, receive and respond ot email and set up folders. Must be able to type a minimum of 25 wpm with a 90% accuracy rate.

Nice To Haves

Bachelor’s degree preferred
Prior experience of accessing hospital EMR’s and Payer Portals preferred

Responsibilities

Perform denial research and follow-up work with insurance companies via phone to resolve appeals that have been submitted but remain without a determination
Compile multiple documents into appeal bundles and submit appeal bundles to payers in a timely manner
Determine and document appeal timeframes and payer process per facility within CorroHealth proprietary system
Transcribe information from clients’ EMRs and payer portals into required electronic format; check completed work for accuracy
Monitor and complete tasks within shared inboxes and internal request dashboards
Receive and document incoming emails, calls, tickets, or voicemails
Follow up with the client or internal staff via email or phone for additional information as requested
Export and upload documents within CorroHealth proprietary system
Cross-trained on various functions within the department to support other teams as needed
Other responsibilities as requested by management