Community Health Systems SSC-Appeals Assistant in Franklin, Tennessee

Description:

Summary : The Appeals Assistant is responsible for providing administrative assistance to the appeal staff in the appeals department. The role involves but is not limited to tracking all appeals, procuring medical records and additional documents needed, maintaining thorough software timelines for appeals, working with the appeals staff to prepare appeals of denied government insurance claims and overall coordination of all appeals activity.

Essential Duties and Responsibilities include the following: (Other duties may be assigned).

  • Track all appeals activity in collaboration with the Director of Denials and Appeals.

  • Maintain all files as needed; provide clerical assistance by typing appeal letters and all other correspondence as requested.

  • Answer all hospital queries and provide guidance to appeals process.

  • Work with CHS facilities to ensure receipt of all necessary medical records either copies or electronically.

  • Assist appeals staff to track and meet appeals deadlines.

  • Create reports of appeals activity and associated deadlines to determine opportunities to improve responses.

Appeals Processes

Maintain a thorough working knowledge of the appeals process and the tracking software.

Work with appeals department staff to identify opportunities to improve the physical workflow processes within the Appeals Unit.

General

  • Maintain acceptable working knowledge of denials and appeal processes

  • Maintain working knowledge of current medical terminology

  • Able to define issues; collect and validate data as needed to help resolve issues

  • Knowledgeable about 3 areas that impact bonus structure: AR days, Bad Debt projections and Cash

  • Perform other duties as assigned by Manager and Director as needed

Qualifications

Knowledge/Abilities:

  • Understanding of the revenue cycle and the responsibility and goals of each area and how they impact the revenue cycle

  • Working knowledge of the revenue cycle

  • Ability to communicate effectively both verbal and written

  • Ability to work independently and to meet deadlines

  • Working knowledge of current medical terminology

  • Working knowledge of denials and appeals processes

Reasoning Ability:

Ability to define problems, collects data, validate data, establish facts, and draw valid conclusions.

Computer Skills:

  • A thorough working knowledge of the appeals process and the tracking software

  • Working knowledge of Outlook, Microsoft Word and Excel or equivalent

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION/EXPERIENCE:

  • High school diploma or equivalent

  • Minimum of one year experience in a healthcare setting

Job: Business Office

Organization: Shared Services Center - Franklin

Location: TN-Franklin

Requisition ID: 1737110