- Research denials and determine if there is a legitimate case for overturning the denial.
- Verify that all pertinent documentation which substantiates the appeal arguments are organized and complete, and that the appeal letter is logically argued. Ensure the documentation utilized is recorded according to internal quality standards. Use the best, most compelling evidence available to support the argument presented in the appeal. Recognize and obtain missing yet necessary documentation to complete the appeals package. Review and verify appeal exhibits/evidence for accuracy.
- Proof-read and edit the appeal letter, as necessary. Ensure appeal letter contains no spelling, grammatical, or syntax errors before being submitted to the client for review.
- Ensure that the appeal is written and submitted according to internal documentation control protocols and timely filing.
- Communicate and collaborate with internal and external team members to promptly, accurately, and professionally address any questions or concerns that arise because of the appeal review or writing and submission process and escalate customer concerns to Inform manager of payor trends or problems or changes in payor requirements.
- Follow up on all Corrected claims and appeals submitted.
- Make clear, detailed notations in EMR system on all accounts worked.
- Calculate expected claim reimbursement.
- Have a working knowledge of payor policy guidelines and payor contracts.
- Have a clear understanding of fee schedules.
- High School Diploma.
- 2 years' experience preferred.
- Excellent verbal and written communication skills.
- Excellent organizational skills and attention to detail.
- Maintains professional friendly attitude.
- Excellent knowledge of payor policies and guidelines.
- Familiarity with coding guidelines.
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Revenue Cycle Representative
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SENTA Partners Sandy Springs, United StatesResearch denials and determine if there is a legitimate case for overturning the denial. · - Verify that all pertinent documentation which substantiates the appeal arguments are organized and complete, and that the appeal letter is logically argued. Ensure the documentation utili ...
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Revenue Cycle Representative
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SENTA Partners Atlanta, United StatesHave Knowledge of ENT and Allergy but not required · Knowledge of Biologics but not required · Research denials and determine if there is a legitimate case for overturning the denial. · Verify that all pertinent documentation which substantiates the appeal arguments are organi ...
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Patient Access Associate
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Diesel Fleet Technician II
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SYSCO Atlanta, United States Full timeCompany: · US0002 Sysco Atlanta, LLCZip Code: · 30337Minimum Level of Education: · High School or EquivalentMinimum Years of Experience: · 3 YearsEmployment Type: · Full TimeTravel Percentage: · 0COMPENSATION INFORMATION: · The pay range provided is not indicative of Sysco's ac ...
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Lavendo Atlanta, United StatesOur client, a top-rated AI-powered IT staffing and IT recruiting company, is on a mission to reimagine how businesses harness talent. As a Business Development Representative (BDR), you will play a crucial role in the company by generating new business opportunities and expanding ...
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Sales Representative
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NuRoof Atlanta, United States**About NuRoof** · NuRoof is the premier roof inspection, restoration, and repair provider in the Greater Atlanta area. NuRoof is led by a passionate team committed to high quality outcomes in every project. · As a Sales Representative at NuRoof, you will be responsible for gener ...
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IT Specialist
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AssuranceAmerica Atlanta, United StatesJOIN THE ASSURANCEAMERICA TEAM · Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. · For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products t ...
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Sr Data Warehouse Engineer
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Salesforce Architect
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CST Industries, Inc. DeKalb, United StatesWe are looking for a Shipping & Receiving Clerk in our DeKalb location. · **Here are some details about this position**: · About CST Industries · Position Summary · This position is responsible for the timely and accurate tracking and importing of information within the Shipping, ...
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Dishwasher
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Flagship Facility Services LLC DeKalb, United StatesIt's fun to work in a company where people truly BELIEVE in what they're doing · - We're committed to bringing passion and customer focus to the business._ · - Check out a day in the life of a Dish Machine Operator here_ · **Job Summary**: · The dishwasher is responsible for main ...
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Shipping & Receiving Supervisor
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Duraco Specialty Tapes LLC #150831 Forest Park, United States**Job Summary**: · The Shipping and Receiving Supervisor directs and manages shipping, receiving, packing and warehouse operations, while working side-by-side with the crew to fulfill customer orders. This individual will ensure efficient receipt of raw materials and expeditious ...
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Direct Sales Representative
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Sales Representative
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Bartlett Roofing Atlanta, United States Full time· Now Hiring for June 2024: Join Our Dynamic Team in our new Atlanta market · We are thrilled to announce that we have expanded into the growing market of Atlanta, Georgia This exciting venture marks a significant milestone in our journey, as we extend our commitment to deliveri ...
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Sales Representative
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Bartlett Roofing Atlanta, United States Full time· Now Hiring for June 2024: Join Our Dynamic Team in our new Atlanta market · We are thrilled to announce that we have expanded into the growing market of Atlanta, Georgia This exciting venture marks a significant milestone in our journey, as we extend our commitment to deliveri ...