Coordinator, Appeals Management

 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:

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.

Job Summary

• 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

Minimum Qualifications:

• 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

Education/Experience Required:

• High School Diploma or equivalent required
• Bachelor’s degree preferred
• Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines
• Prior experience of accessing hospital EMR’s and Payer Portals preferred
• 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.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.