Appeals Assistant

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Collaborates and coordinates with all members of the healthcare team, patients, and families (or significant others) to facilitate and ensure the timely and efficient delivery of necessary workflows, services, and tasks.

• Executes timely and precise denial communications and activities; clarifies communications when necessary, and gathers additional information in preparation for Nurse review.

• Assists the denial/appeal management nurse in working with physicians, UM Nurses, PAS, and other members of the Interdisciplinary team, Revenue Cycle, and payers to gather and communicate all relevant information to support successful appeals.

• Records appeal activities in accordance with department standards to ensure accurate reporting.

• Investigates and logs appeal outcomes and generates reports related to denial and appeal results.

⛳️ Requirements

• High School Equivalent / GED (Required)

• Associate's Degree (Preferred)

• 2+ years of experience in hospital or physician office billing or Utilization Management/Case Management department (Required)

• Experience in managed care (Preferred)

• Detail-oriented and organized, possessing strong analytical and problem-solving abilities.

• Excellent client service, communication, presentation, and relationship-building skills.

• Capable of functioning independently as well as part of a team in a fast-paced environment.

• Must demonstrate strong written and verbal communication skills.

• Proven ability to operate PCs, Microsoft Office suite, and general office equipment (such as printers, copy machines, FAX machines, etc.).

• Strong typing skills.

• Knowledge of Medical Terminology.

🏝️ Benefits

• Complies with all policies and standards.

• Annual training, along with the UH Code of Conduct and UH policies and procedures, are established to ensure appropriate use of PHI in the workplace.