APPEALS SPECIALIST

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO) delivers comprehensive insurance revenue services to affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture.

Responsibilities

• Manage denied claims by identifying reasons for denial or dispute and collaborate closely with Nurse Auditors to support medical necessity appeals.
• Prepare and submit accurate appeal documentation.
• Conduct thorough research to gather supporting evidence for appeals.
• Ensure timely follow-up and resolution of appeals.
• Track the status of appeals, follow up regularly, and escalate issues as needed to facilitate timely resolution.
• Apply critical thinking and attention to detail in reviewing claims and related documentation.
• Utilize interpersonal skills to effectively communicate and collaborate with internal teams and external parties.
• Leverage experience with hospital acute care payer contracts to support claim resolution and appeals processes.

Requirements

• 2 years of healthcare/collection experience and/or equivalent experience in a hospital setting.
• Minimum of 2 years of previous Collections/Appeals experience.
• High school diploma or equivalent.

Schedule

7:30 AM - 4:00 PM

Benefits

• Competitive compensation.
• Excellent medical, dental, vision, and prescription drug plan.
• 401k plan with company match.
• Career training and support for continued professional development.
• Growth and development opportunities within UHS and its subsidiaries.

Universal Health Services (UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services, recognized as one of the World’s Most Admired Companies by Fortune and listed in Forbes ranking of America’s Largest Public Companies. UHS operates acute care hospitals, behavioral health facilities, outpatient facilities, ambulatory care access points, an insurance offering, a physician network, and various related services across the U.S., Washington, D.C., Puerto Rico, and the United Kingdom.