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Appeals Discrepancy Specialist
hace 1 semana
**Job Summary**
You will be working for a leading business process outsourcing provider to support one of their largest accounts in the healthcare industry. This provider serves numerous hospitals and physician practices with millions of patient encounters annually.
As an appeals underpayment collector, you will monitor the claims process to ensure timely reimbursement to the provider, keeping medical expenses fair to patients. Key responsibilities include:
- Triage incoming inventory for the Appeals team, verifying appeal criteria are met
- Compose technical denial arguments for reconsideration, including written and telephonic presentations
- Identify contract protections that can be leveraged to overturn denials
- Overcome objections preventing payment of claims and gain commitment through concise appeal arguments
- Identify problem accounts/processes/trends and escalate as necessary
- Utilize effective documentation standards supporting a strong historical record of actions taken
- Perform basic math to ensure accurate statements of accounts receivable
This role requires strong customer service skills, excellent communication abilities, attention to detail, and comfort multitasking in a high-volume environment. You will work independently and collaboratively to meet productivity and quality standards.
