Appeals Specialist

hace 3 semanas

San Francisco, Heredia, Costa Rica Auxis A tiempo completo

Job Summary:
You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.
This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.
As an appeals non-clinical collector for one of the leading healthcare services providers, you will be monitoring the claims process to ensure timely reimbursement to the provider to keep medical expenses fair to the patient.
**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:

- English - Spanish Language (Oral and writing 85% or higher), (C1 or above).
- Must have a high school diploma or in progress to complete high school.
- At least 6 months of experience in Customer Service positions.
- This job adjusts to the Eastern Time Zone and follows a US holiday schedule.
- Strong customer service skills
- Excellent communication skills
- Ability to work independently and collaboratively
- Attention to detail
- Comfortable multitasking in a high volume/high demand environment
- Good presentation and a polite, tactful, and friendly character.
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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