Appeals Specialist

Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career opportunity? Have you recently been seeking out prestigious, national healthcare companies with which to further your longterm goals? Are you seeking REAL advancement opportunities in-house with a Fortune 500 company? If you answered “yes" to any of these questions – then this opportunity may be for you!

Daily Responsibilities:

In this role, you will be responsible for validating disputes presented on EOBs, entering denied claims into company database & escalating paymment/variance trends to management

Responsibilities:

Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons

Coordinates for clinical consultations or account referrals when necessary

Generate an appeal based on the dispute reason and contract terms specific to payer

Follow specific payer guidelines for appeals submission

Escalate exhausted appeal efforts for resolution

Review denial reasons on EOBs to determine denials

Enter denied claims into database

Work payer projects as directed

Identify denial & variance trends

Shift: Monday - Friday / 8:00 am – 4:30 pm

Advantages of this Opportunity:

Competitive hourly pay above regional average!

Longterm stability and individual professional growth potential from a national Healthcare company that continues to grow!

Daytime, weekday schedule.

You will have the opportunity to add great experience to your resume, while getting the chance to network with several future colleagues in a highly-competitive insurance claims field.

What We Look For:

1-2 years in a healthcare administrative environment performing billing and/or collections

3-5 years of A/R follow up with insurance on claims (direct contract with insurancess

Full understanding of the insurance denials / appeals process

Excellent computer skills with emphasis on use of Excel spreadsheets

High School Diploma or GED