What are the responsibilities and job description for the Appeals Specialist - Business Office - Days position at BHST?
We are looking to add top talent to our Baptist Hospitals of Southeast Texas team.
Join us in performing Sacred Work!
Competitive benefits are offered including:
Matched Retirement Plan
Paid Time Off
Comprehensive Benefit Plan – Medical, Dental, Vision and Much More!
Bonus Potential
Summary/Objective
The Appeals Specialist is responsible for working appeals on denied claims. Ensures all denied claims are entered into the database and appeals are sent timely to all payers. Works with medical necessity compliance and Appeals Company and attorneys for claims resolution.
Essential Job Duties
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Works denied claims timely within goals established by management.
- Sends appeal or recommends write off to management on denied claims.
- Ensures denial information is entered into appropriate system to facilitate collection of accounts.
- Monitors and identifies trends resulting in increased denials and notifies appropriate person for corrective action.
- Works with outside departments, providers and insurance companies to facilitate billing and collection of claims.
- Works with patients to resolve issues and facilitate billing and collection of claims.
Required Education and Experience
High School diploma or equivalent
1 - 3 years related experience
Required License/Certifications
N/A