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Appeals Analyst - Health

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Healthcare
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196063 Requisition #
Thanks for your interest in the Appeals Analyst - Health position. Unfortunately this position has been closed but you can search our 557 open jobs by clicking here.

Education and Experience: 
• Associates degree preferred
• Minimum of two years’ experience working with managed care claims and appeals for health care professional services (physicians and other health care professionals).
• Experience in a production environment desirable but comfort in such an environment is essential.
Equivalent combination of education and experience may be considered

Knowledge: 
• Advanced knowledge and PC skills, with proficiency in utilizing Microsoft office products (Word, Excel, Outlook, PowerPoint, etc.)
• Knowledge of the health care professional services billing (physicians and related health care professionals) and reimbursement environment.
• Knowledge of major types of practice management system (PMS) and EOB imaging systems, with experience working with at least one industry leading PMS highly desirable.
• Knowledge of medical terminology.
• Knowledge of networks, IPAs, MSOs, HMOs, PCP and contract affiliations.
• Knowledge of managed care contracts and compliance.
Skills: 
• Demonstrated skill in gathering and reporting claims information.
• Demonstrated skill in written and oral communication with colleagues, supervisors, and payer/network personnel.
• Demonstrated skill working in a team-oriented structure to achieve goals.
• Demonstrated skill in problem solving and research. 
Abilities: 
• Ability to work effectively with other departments and management.
• Ability to identify, analyze and solve problems and to recognize patterns in data.
• Ability to learn, understand and use the software application.

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