Appeal Resolution Specialist jobs in Indiana

Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Medical Appeal/Denial Specialist
  • US Oncology Network-wide Career Opportunities
  • Evansville, IN FULL_TIME
  • Overview

    Employment Type: Full Time

    In-Office Position

    Benefits: M/D/V, Life Ins., 401(k)

    Evansville, IN

    SCOPE: With minimal supervision, is responsible for payer and patient account balances being paid timely and remaining current. Performs collection activities such as monitoring delinquent accounts, contacting patients for account payment, resolving billing problems, and answering routine to complex account inquiries. Performs responsibilities within standard procedures and pre-established guidelines to complete tasks. A certain degree of creativity and latitude is required. Supports and adheres to The US Oncology's Compliance Program, to include the Code of Ethics and Business Standards, and The US Oncology's Shared Values

    The US Oncology Network is a thriving organization that fosters forward-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join our team in the fight against cancer!

    About US Oncology

    The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care. For more information, visit
    . We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401-K with a matching component, Life Insurance, Short-term and Long-term disability, and Wellness & Perks Programs.



    Responsibilities

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    * Monitors delinquent accounts and performs collection duties

    * Reviews reports, researches and resolves issues

    * Reviews payment postings for accuracy and to ensure account balances are current

    * Works with co-workers to resolve insurance payment and billing errors

    * Monitors and updates delinquent accounts status

    * Recommends accounts for collection or write-off

    * Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations.

    * Answers patient payment, billing, and insurance questions and resolves complaints.

    * Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations

    * Answers patient payment, billing, and insurance questions and resolves complaints

    * May refer patients to Patient Benefits Representative to set up payment plans

    * Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations

    * Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records

    * Performs other duties as requested or assigned



    Qualifications

    MINIMUM QUALIFICATIONS

    * High School diploma or equivalent required

    * Minimum two (2) years combined medical billing and payment experience required

    * Demonstrate knowledge of state, federal, and third party claims processing required

    * Demonstrate knowledge of state & federal collections guidelines

    * Must successfully complete required e-learning courses within 90 days of occupying position

    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. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

    WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.


    The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

     

  • 1 Day Ago

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Marketing Specialist
  • Resolution Group, Inc.
  • Indianapolis, IN FULL_TIME
  • OverviewResolution Group, Inc ("RGI") seeks a skilled, highly motivated, results-driven Marketing Specialist to join our dynamic team. Working out of our Indianapolis, IN office, this challenging and ...
  • 4 Days Ago

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Account Resolution Specialist
  • American Coradius
  • Carmel, IN FULL_TIME
  • Collectors ~ REMOTE ROLE/NO WEEKENDS! Welcome to ACI, Your Employer of Choice Since 1989! American Coradius International LLC (ACI) is based in Amherst NY where we started doing business over 34 years...
  • 2 Days Ago

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Denials Resolution Specialist
  • Community Foundation of Northwest Indiana
  • Munster, IN FULL_TIME
  • Community Healthcare System is hiring a Denials Resolution Specialist Under the direction of the Director of Utilization / Case Management / Social Service, the Denials Resolution Specialist reviews, ...
  • 3 Days Ago

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Sr. Dispute Resolution Specialist
  • OneMain Financial
  • Evansville, IN FULL_TIME
  • The Credit Bureau Disputes Department's primary responsibility is to research and respond to all credit reporting disputes received by the Company. Key responsibilities for the department include rese...
  • 12 Days Ago

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Account Resolution (Collections) Specialist
  • American Coadius
  • Carmel, IN FULL_TIME
  • Collectors ~ REMOTE ROLE/NO WEEKENDS!Welcome to ACI, Your Employer of Choice Since 1989! American Coradius International LLC (ACI) is based in Amherst NY where we started doing business over 34 years ...
  • 1 Month Ago

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PKI Subject Matter Expert
  • Dunhill Professional Search & Government Solutions
  • Germantown, MD
  • PKI Subject Matter Expert *Full Time Telework *U.S. Citizenship Required Job Role and Duties: Enforces application secur...
  • 3/28/2024 12:00:00 AM

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Transportation Subject Matter Expert
  • Bowhead / UIC Technical Services
  • Aberdeen, MD
  • Overview At Bowhead, our employees have incredible opportunities to work with exciting military applications and equipm...
  • 3/28/2024 12:00:00 AM

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Subject Matter Expert
  • HCL Technologies Ltd.
  • Fairfield, CT
  • Job Description (Posting). Job Description:Candidate needs familiarity with SAP ECC release 4.5 (prior to new GL) Senior...
  • 3/28/2024 12:00:00 AM

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Egnyte Subject Matter Expert
  • Cogliano IT Staffing
  • Myrtle Point, OR
  • Egnyte Subject Matter Expert (Pre-Sales and Implementation) needed for a 6+ month contract working remotely from within ...
  • 3/28/2024 12:00:00 AM

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S1000D Subject Matter Expert
  • Digitized Schematic Solutions LLC
  • Oklahoma City, OK
  • Job Summary: The Subject Matter Expert will support database administration of a TDSSe2 project. We are seeking a highly...
  • 3/27/2024 12:00:00 AM

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S1000D Subject Matter Expert
  • Digitized Schematic Solutions LLC
  • Haddock, GA
  • Job Summary: The Subject Matter Expert will support database administration of a TDSSe2 project. We are seeking a highly...
  • 3/27/2024 12:00:00 AM

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PKI Subject Matter Expert
  • Dunhill Professional Search
  • Germantown, MD
  • PKI Subject Matter Expert *Full Time Telework *U.S. Citizenship Required Job Role and Duties: Enforces application secur...
  • 3/26/2024 12:00:00 AM

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IT Subject Matter Expert
  • Contact Government Services, LLC
  • Hollywood, FL
  • IT Subject Matter Expert Employment Type: Full Time, Experienced level Department: Information Technology As an IT Subje...
  • 3/26/2024 12:00:00 AM

Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west. Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$46,317 to $57,376

Appeal Resolution Specialist in Tallahassee, FL
Are you interested in a position that supports the federal judiciary's mission of ensuring equal justice under the law? Come join our talented and diverse team at the Court of Appeals! About the Court The United States Court of Appeals for the 9th.
December 31, 2019
Appeal Resolution Specialist in Monterey, CA
SummaryThe Appeals Manager Owns the output of a single work area within Appeals and typically manages a team of Appeals job family roles.
December 28, 2019
Appeal Resolution Specialist in Middlesex, NJ
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, pharmacy and vision decisions.
January 25, 2020