Job Details

Responsible for pursuing denied accounts, timely and accurate follow-up to address and improve resolution of payment delays, updating/reprocessing claims, submitting reconsiderations/appeals within proper filing timeframe to achieve optimal payment for services rendered. Denials and appeals specialists must be knowledgeable of payer requirements, experienced in claim resolution, identify, expedite and escalate trends to management, demonstrate exceptional relationships with external/internal payers as well as internal departments in accordance with Prisma Health Standard of Behaviors and Compliance. Essential Functions. All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Responsible for resolution of denied claims and/or initiate/manage/follow-up on reconsiderations/appeals in a timely manner. -Monitors denial work queues and reports in accordance with assignments from direct supervis...Appeals Specialist, Appeals, Specialist, Remote, Management, Healthcare