Appeals analyst - experian health

Descripción general

The Healthcare Appeals Analyst is responsible for monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.

Requisitos para aplicar

• High School diploma (minimum)
• Minimum of two years’ experience working with managed care claims and appeals for health care professional services (physicians and other health care professionals).
• 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.
• Strong English communication (written and oral) with colleagues, supervisors, and payer/network personnel.