Coordinator, Appeals Management

About Our Company

We are dedicated to assisting clients in surpassing their financial health objectives. Through comprehensive solutions across the reimbursement cycle and leveraging clinical expertise alongside advanced technology and analytics, we provide tailored services to meet evolving client needs. Our commitment extends to fostering career growth and professional development to ensure mutual success.

Role Overview

This position supports healthcare providers by managing denial appeals remotely within the United States. The role involves detailed research, communication, documentation, and timely submission of appeals using proprietary systems and client resources.

Key Responsibilities

• Investigate and follow up on denial cases with insurers via phone to resolve outstanding appeals.
• Assemble necessary documentation into appeal packages and ensure prompt delivery to payers.
• Identify and record appeal deadlines and procedures for each facility using internal systems.
• Accurately transcribe data from client electronic medical records and payer portals into required digital formats.
• Manage tasks within shared email inboxes and internal request dashboards efficiently.
• Log and document communications received through emails, calls, tickets, or voicemails.
• Coordinate with clients or internal teams to obtain additional information when necessary.
• Manage exporting and uploading of documents within the company’s proprietary platform.
• Provide cross-functional support by being trained on multiple departmental roles.
• Fulfill other duties assigned by management as needed.

Candidate Requirements

• Enthusiastic about phone communication and customer interaction.
• Proficient with computers, demonstrating intermediate skills in Microsoft Outlook and Excel.
• Capable of scheduling meetings and using Microsoft Teams effectively.
• Competent in Excel operations including creating new workbooks, basic formulas (addition, subtraction), and copy-pasting data.
• Typing speed of at least 25 words per minute with good accuracy.
• Strong attention to detail and initiative in resolving issues.
• Ability to work independently while collaborating within a team environment.
• Comfortable managing tasks in a fast-paced setting.
• Excellent verbal and written communication capabilities.
• Committed to maintaining confidentiality of sensitive and client information.
• Strict compliance with HIPAA and HITECH regulations.

Education and Experience

• High school diploma or equivalent compulsory; bachelor’s degree preferred.
• Familiarity with denial processes related to Medicare, Medicaid, and Commercial/Managed Care insurance products.
• Experience with hospital EMRs and payer portals is advantageous.
• Proficiency in Microsoft Word and Excel; capable of basic workbook manipulations and formula usage.
• Basic Outlook skills including managing emails and calendar invitations.
• A minimum typing speed of 25 wpm with 90% accuracy.

Employment Details

• Work Schedule: Monday through Friday, 8:00 AM to 5:00 PM Eastern Standard Time.
• This is exclusively a remote position within the United States.

Compensation and Benefits

• Competitive hourly wage.
• Medical, dental, and vision insurance coverage.
• Equipment provided for remote work setup.
• 401(k) retirement program.
• Paid time off accrual of 80 hours annually, plus paid holidays.
• Tuition reimbursement opportunities.
• Professional growth and advancement possibilities.

Physical Requirements

Reasonable accommodations are available to assist individuals with disabilities in performing essential duties. The role involves regular hand-eye coordination and dexterity to operate office tools and computers for 6-8 hours daily, often in environments with frequent interruptions. Extended sitting periods may be required. Occasionally, the job necessitates lifting items up to 20 pounds. The position may include elevated stress levels during peak workloads and multiple deadlines.

Additional Notes

This job description represents key responsibilities and qualifications but is not exhaustive. Additional duties may be assigned by supervisors as deemed appropriate.