- Career Growth Opportunities
- Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
- 401K program (Discretionary matching funds available)
- Employee Assistance Program
- Referral Program
- Dental plans & Vision plans
- GENEROUS Personal time off
- Eight Paid Holidays per year
- Quarterly incentive plans
- Employee of the month awards with monetary gift and parking space
- Training Programs
- Fitness Center with personal trainer on site
- Wellness programs
- Flexible work schedule
- Reviews ETM list to identify trends and carrier issues that need to be reported to management.
- Reviews ETM appeal role denials to determine appropriate action based on carrier requirements.
- Assembles and prepares documentation in Waystar system to carrier to appeal disputed claims.
- Assembles, prepares and forwards documentation on Medicaid CA and WC to appeal disputed claims.
- Handles correspondence related to Medicare, Medicaid, Blue Cross Blue Shield, Managed Care and Tenncare according to written procedure.
- Assembles and forwards appropriate documentation to the Senior Representative for provider related issues.
- Maintain knowledge of carrier requirements for appeal completion.
- Maintain knowledge of ETM system.
- Maintain knowledge of Waystar appeals processes.
- Report any consistent errors found during review that affect claims from being processed correctly.
- Participates in monthly meeting with Appeals Supervisor.
- Turns to Supervisor for unusual circumstances that may include write-offs, denials, fee schedules, claims, etc.
- Performs any and all duties as directed by Senior Representative, Appeals Supervisor and Accounts Receivable Manager.
- Demonstrated knowledge of physician billing.
- Demonstrated knowledge of health care reimbursement guidelines.
- Knowledge of ICD-10 and CPT-4 coding.
- Excellent oral and written communication.
- Detailed in completing Appeal documentation.
- Knowledge of appeals and review policies for all plans.
- Thorough working knowledge of physician billing policies and procedures.
- Computer literate.
- Excellent follow-up skills.
- Excellent organizational skills.
- High school diploma or equivalent.
- Minimum two years previous medical billing experience preferred with emphasis on research and claim denials in Accounts Receivable.
- Training classes and seminar attendance may require travel.
- None
-
Accounts Receivable Representative, Anesthesia
2 weeks ago
TeamHealth Louisville, United StatesThe TeamHealth Anesthesia Billing Center has an immediate opening for an Accounts Receivable Representative · This position offers remote work following on-site training at our facility in Louisville, TN · TeamHealth is named among the "150 Great Places to Work in Healthcare" by ...
-
Remote Data Entry Representative
2 weeks ago
TeamHealth Louisville, TN, United StatesTeamHealth has ranked three years running as "The World's Most Admired Companies" by Fortune Magazine and one of America's 100 Most Trustworthy Companies by Forbes Magazine in past years. TeamHealth, an established healthcare organization is physician-led and patient-focused. We ...
-
Billing Representative
2 weeks ago
TeamHealth Louisville, TN, United StatesJoin a team of dynamic, results oriented professionals · Named among "The World's Most Admired Companies" by Fortune Magazine · Named among "America's 100 Most Trustworthy Companies" by Forbes magazine · Named among "Great Places to Work" by Becker's Hospital Review · ~ Career ...
-
Medical Billing Account Receivable Specialists
2 weeks ago
TeamHealth Alcoa, TN, United StatesJoin a team of dynamic, results oriented professionals · Named among "The World's Most Admired Companies" by Fortune Magazine · Named among "America's 100 Most Trustworthy Companies" by Forbes magazine · Named among "Great Places to Work" by Becker's Hospital Review · ~ Career ...
-
Vice President and Dean of Students
6 days ago
Maryville College Maryville, United StatesJob Details · Job Location · Maryville College - Maryville, TN · Position Type · Full Time · Education Level · Graduate Degree · Travel Percentage · Negligible · Job Shift · Day · Job Category · Education · Description · Vice President and Dean of Students · Maryville ...
-
Vice President and Dean of Students
2 days ago
Maryville College Maryville, United StatesJob Details · Job Location · Maryville College - Maryville, TN · Position Type · Full Time · Education Level · Graduate Degree · Travel Percentage · Negligible · Job Shift · Day · Job Category · Education · Description · Vice President and Dean of Students · Maryville ...
-
Web Designer
2 weeks ago
Keller Group, LLC Knoxville, United StatesJob Description · Job DescriptionDescription:Title: Web Designer · Location: In-Office · Position Type: Full Time · We are seeking a creative and talented Web Designer to join our Keller Creative Agency team · full-time in Knoxville, Tennessee. The ideal candidate will have a str ...
-
Area Food
1 day ago
Marriott Knoxville Downtown Knoxville, Tennessee, United States PermanentJob Summary: · The Food & Beverage Director is responsible for assuring attentive friendly courteous and efficient service in all F&B Outlets (Restaurant Room Service Lounge Market and Banquets) while maintaining adherence to budgeted payroll and overhead cost. He/she is also res ...
-
AR Specialist
2 weeks ago
Tennessee Orthopaedic Clinics Knoxville, United StatesABOUT TOA · Tennessee Orthopaedic Alliance is one of the nation's largest orthopedic networks. TOA offers comprehensive medical and surgical treatment of bone, joint and soft tissue disorders. Our treatment is compassionate, conservative and prompt, providing patients with the s ...
-
Associate Dentist- Sign on Bonus
2 weeks ago
Riccobene Associates Family Dentistry Fort Mill, United StatesJob Description · Job DescriptionAssociate Dentist · POSITION SUMMARY · The Associate Dentist (AD) is responsible for administering, maintaining, and expanding a program of primary (and in selected cases, secondary) care and preventive dental care in a group practice setting. AD ...
-
Fine Jewelry Counter Manager
2 weeks ago
Belk Knoxville, United States OTHERAt Belk, we have a vision to reimagine the department store. As a Fine Jewelry Counter Manager, you will drive store sales and metrics through providing excellent customer service to each customer and through the execution of customer-facing merchandising standards throughout the ...
-
Line Cook PM
2 weeks ago
Marriott Knoxville Downtown Knoxville, United StatesJob Summary: · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produ ...
-
Line Cook PM
3 weeks ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Line Cook PM
1 week ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Line Cook AM
2 weeks ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Line Cook PM
3 weeks ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Grill Cook/Broiler
3 weeks ago
Ruths Chris Knoxville, United States** Grill Cook/Broiler** · **Job Category****:** Non-Tipped Employee **Requisition Number****:** BROIL005347 Showing 1 location **Job Details** · **Description** · ***Urgently Hiring*** · Get ready for the BEST JOB you ever had · **What We Offer:** Flexible and predictable sc ...
-
Line Cook AM
6 days ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Line Cook PM
1 week ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
-
Line Cook PM
2 weeks ago
Aimbridge Hospitality Knoxville, United StatesJob Summary · A line-Cook is responsible for preparing / cooking all food items based on standardized recipes for the Corporate HQ outlet Banquets/Catering in meeting rooms and Executive Lounge while maintaining the highest standards to produce an appealing and appetizing produc ...
Appeals Representative - Louisville, TN, United States - TeamHealth
Description
Join a team of dynamic, results oriented professionals
Named among "The World's Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among "Great Places to Work" by Becker's Hospital Review
JOB DESCRIPTION OVERVIEW:
Position is responsible for reviewing denials assigned to Appeals Role in ETM System and processing appeal from Waystar Appeal system.
Maintains accuracy and production to ensure denials are being processed efficiently. Responsibilities of position includes, but not limited to the following:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
QUALIFICATIONS / EXPERIENCE:
SUPERVISORY RESPONSIBILITIES:
PHYSICAL / ENVIRONMENTAL DEMANDS:
This job will be performed in a well-lighted and well-vented environment. Work is oriented around good visual skills. Eye fatigue may be encountered as extended amount of time is spent in front of computer.
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
Overtime may be required and can be mandated by Management.
DISCLAIMER:
Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.
