Denials And Appeals Specialist - REMOTE
 TEKsystems | |
$18.00 - $20.00 / hr
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medical insurance, life insurance, sick time, 401(k), retirement plan
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 United States, Florida, Sarasota | |
 Mar 06, 2025 | |
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*Description*
1. Manages workflow for Humana PPI Audits, RAC Audits, or outpatient appeals and communicates daily with Sr. Director/Manager on trends identified 2. Respond to queries within 72 hours, appropriately documents in Cerner/ClaimIQ/Artiva and tracks all activity in the appeal tracker 3. Manages PDFU to assure timely follow up of accounts to effectively move through the revenue cycle 4. Completes claim appeals and assists with other projects as needed 5. Submits requests for medical records, ub's, and itemized bills as needed 6. Responsible for being aware of the current department policies and procedures 7. Meet or exceed quality and quantity benchmark targets as established by management 8. Ability to perform all other duties as assigned or requested 9. Ensure confidentiality of all patient accounts by following HIPPA guidelines *Skills* appeals, Denials, Medical Claims, Accounts receivable, medical collections, insurance verification, collections *Top Skills Details* appeals,Denials,Medical Claims *Additional Skills & Qualifications* Appeals and denials medical claims medical appeals medical denials insurance claims medical insurance Surgical Verification -Radiology Verification Insurance verification healthcare customer service oncology experience -healthcare collections -medical collections -patient service specialist *Experience Level* Entry Level *Pay and Benefits* The pay range for this position is $18.00 - $20.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type* This is a fully remote position. *Application Deadline* This position is anticipated to close on Mar 19, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. | |