caf
Appeals Specialist
Gardena, California · Full-time
Sponsorship not specifiedDetected 20 days ago
ExcelCustomer SupportCernerResearchCommunication
About the role
- APPEALS SPECIALIST Do you like challeng ing payers?
- That f eeling of satisfaction when your appeal is overturned?
- Then, this position may be right for you!
Responsibilities
- Developing well-supported appeal arguments, where an appeal is warranted.
- Perform follow up on any outstanding claims, manage correspondence and requests and research denials and zero payments.
- Ability to perform critical work under deadlines.
Requirements
- 3 to 5+ years of recent experience writing insurance appeals and pursuing payers for collection on behalf of hospitals (facility charges).
- Knowledge of Milliman/InterQual guidelines
- Ability to pass a thorough background check and drug screen.
- Ability to work in a changing environment and handle multiple tasks
Nice to have
- Compiling appeals and collecting for hospital/facility component with general knowledge of insurance follow - up
- Experience with billing and collection systems such as CUBS, Meditech, Cerner etc.
Compensation
- Full-time position.
- Pay commensurate with experience.
- Paid training.
- Plenty of growth opportunities for friendly, focused, results-driven people.
Benefits
- Generous paid vacation, holidays, 401k, Aflac supplemental insurance (at employee expense), and monthly bonus opportunities for those who qualify.
- No company paid medical benefits at this time.
- Understanding of medical terminology, bill review, general coding, and appeals resolution.
- Ability to read, analyze, and interpret hospital medical bills, records, statutes, contracts, and other relevant documents.
- Knowledge of medical necessity, time filing, UCR and contract denials.
- CAF is a fast-growing revenue cycle agency exclusively serving hospitals, and conveniently located at the intersection of the 405 and 110 freeways.
- We utilize amazing customer service to help hospitals bill, service and collect more of the money they are due, so they may continue to provide critical healthcare services to their patients.
This listing is sourced directly from caf's careers page and normalized into a canonical job model.