Appeals Representative

We are seeking a detail-oriented and compassionate Appeals Representative to join an excellent Healthcare Company in Fort Worth, TX! In this role, you will be responsible for reviewing and processing appeals and grievances from patients and providers, ensuring that all cases are resolved promptly and in accordance with regulatory guidelines. The ideal candidate will have a strong background in healthcare administration or insurance, excellent analytical skills, and a passion for helping others.

JOB ID - 145922

Job Title: Appeals Representative

TEMP TO HIRE

Pay: $17-19/hr - Depending on Experience

Location: Southwest Fort Worth, TX (Clearfork)

• Will move remote once permanent

Hours: Monday - Friday, 8AM - 5PM

JOB SUMMARY: The Appeals Representative I is responsible for addressing provider inquiries and appeals via email, fax, telephone, or written correspondence ensuring adherence to client policy, industry standards along with CMS and state guidelines as well as client instructions.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Reviews, analyzes, and completes appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication.

• Ability to appropriately interpret provider appeals and apply analytical thinking skills.

• Ability to interpret client policy and CMS guidelines as it relates to reviews done by the client such as itemized bill.

• Utilize applicable tools and resources to complete appeals.

• Timely completion of appeals.

• Additional duties as assigned.

KNOWLEDGE & SKILLS:

• Prior knowledge of inpatient and outpatient hospital revenue cycle required.

• Excellent written and verbal communication skills.

• Contract interpretation, medical terminology and coding knowledge.

• Proficiency with Microsoft applications.

EDUCATION/EXPERIENCE:

• High school diploma or equivalent

• SalesForce experience is a plus.

• 3+ years of healthcare revenue cycle experience (collections, appeals, denials management, etc)

• 2+ years working with customers in a fast-paced, deadline-oriented environment

• 2+ years experience as an Appeals Representative.

• Strong attention to detail, organizational and time management skills with the ability to interpret, research and identify core issues

• Strong customer focus, analytical and decision making skills

To Apply for this Job:

Click the Apply Online button, then:

• If you are currently registered with CornerStone Staffing, click the Log In button to add yourself as a candidate to this job.

• If you are NOT currently registered with CornerStone Staffing, click the Create Accountbutton to complete the application.

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