AR Denials Management and Appeals Specialist, 250 E Liberty, 8:00a-4:30p

Job Description

UofL Health is a not-for-profit 501(c)(3) fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, more than 250 physician practice locations, and more than 1,200 providers in Louisville and the surrounding counties, including southern Indiana. With more than 14,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care.

Essential Functions

• Reviews and determines reason for insurance denial of claims
• Appeals unpaid claims daily and submits appeal timely
• Develops appeal letters to substantiate overturning denial, i.e. coverage, authorization, non-covered services, contract issues, timely filing limit, etc.
• Tracks and trends progress and outcomes of denial and appeal processes and compiles reports for Revenue Cycle leadership
• Completes follow-up work on appealed claims
• Works with insurance carriers on appeal issues
• Ensures clinical appeals are submitted to the appropriate department
• Maintains compliance with all company policies, procedures and standards of conduct
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
• Attends continuing education programs
• Performs other duties and employment requirements as assigned

Additional Job Description

• High School education or GED required
• 1-3 years of prior billing, collection, or appeals experience

Job Competency

• Knowledge of medical terminology
• Clear and concise written communication skills and development of professional letters
• Basic Microsoft Office knowledge
• Ability to foresee projects from start to finish