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Essential Duties and Responsibilities (List in order of importance or percentage of time spent on the particular responsibility – High to Low | |
1. | Manages workflow for Humana PPI Audits, RAC Audits, or Outpatient Appeals and communicates daily with Sr. Director/Manager on trends identified |
2. | Responds to queries within 72hrs, appropriately documents in Cerner/ClaimIQ/Artiva, and tracks all activity in the Appeal Tracker. |
3. | Manages PDFU to assure timely follow-up of accounts to effectively move through the revenue cycle |
4. | Completes claim appeals and assists with other projects, as needed. |
5. | Submits requests for medical records, ub’s, and itemized bills as needed. |
6. | Responsible for being aware of the current department policies and procedures |
7. | Meet or exceed quality and quantity benchmark targets as established by management (productivity, AR days, Cash Collections, Bad Debt, Past Due Follow Up) |
8. | Ability to perform all other duties as assigned or requested |
9. | Ensure confidentiality of all patient accounts by following HIPAA guidelines |
Full Time
$61k-74k (estimate)
04/25/2023
06/27/2024
The job skills required for Appeals Specialist I include Confidentiality, HIPAA, etc. Having related job skills and expertise will give you an advantage when applying to be an Appeals Specialist I. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Appeals Specialist I. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Appeals Specialist I positions, which can be used as a reference in future career path planning. As an Appeals Specialist I, it can be promoted into senior positions as an Appeal Resolution Senior Specialist that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Appeals Specialist I. You can explore the career advancement for an Appeals Specialist I below and select your interested title to get hiring information.