SR APPEALS SPECIALIST

Responsibilities

The Senior Appeals Specialist supports the Appeals team by providing training and guidance. They manage denied claims by identifying reasons for denial or dispute and collaborate closely with Nurse Auditors to support medical necessity appeals. This role involves preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring timely follow-up and resolution of appeals.

Education Qualifications

• High school diploma or equivalent

Experience

• 2+ years healthcare/collection experience and/or equivalent experience in a hospital setting
• Minimum of 2 years of previous Collections/Appeals experience
• Experience in healthcare billing, patient accounts, explanation of benefits, medical insurance verification, and revenue cycle operations
• Familiarity with denial management, collections, and appeals
• Strong attention to detail and auditing experience
• Strong Microsoft Office (Excel and Word) and 10-key data entry skills

Requirements

This Opportunity Offers The Following:

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its Subsidiaries
• Competitive Compensation
• Excellent Medical, Dental, Vision and Prescription Drug Plan
• 401k plan with company match

Benefits

• Comprehensive insurance revenue services to affiliated UHS facilities
• Support for continued professional development

Pay

Competitive compensation

Schedule

N/A