Appeals Specialist

hace 4 semanas

Heredia, Costa Rica Auxis A tiempo completo

Job Summary:
***The Appeals Specialist is responsible for performing end to end tasks for technical appeals.

**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
- Identify problem accounts/processes/trends and escalate as appropriate
- Utilize effective documentation standards that support a strong historical record of actions taken on the
- 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”

Skills and Experience:

- **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
- ** Policies & Procedures** - demonstrates knowledge and understanding of organizational policies, procedures and systems
- ** Technical skills**:

- Professional presentation skills needed to represent facilities in legal
- ** 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
- ** Education** -High School Diploma
- ** English** - Written and verbal communication skills in English (English Level B2).

About Auxis:
Auxis prioritizes employee growth and development to help you advance your career. Auxis’ culture empowers you to be your best in the interest of a common team goal. We are constantly striving to improve our culture and environment and have invested in tools to continue to have better visualization of the pulse of our organization.
- Benefits_
- Health benefits including medical, vision, and dental.
- Transportation subsidy
- Asociacion Solidarista
- Training and development programs
- Employee recognition program
- Paid time off and family paid leave
- Paid day off for your birthday

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