RWJBarnabas Health · 3 hours ago
Appeals Analyst, Fulltime, Remote, NJ
Oceanport, NJ
Full-time
Remote
Entry, Mid Level
2+ years exp
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Responsibilities
Analyzes and researches denials, follows-up with the payer to resolve denials
Reviews applicable timeframes governing the appeal process
Contacts appropriate third party for outcome of clinical appeal
Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal)
Documents accurately and timely the follow-up requirement on denials
Maximize utilization of Contract Management tools and efficient use of existing resources to support cash collection activities
Exercise judgment pertaining to highly sensitive and confidential information
Understanding of claims processing
Demonstrated ability to work independently and on a team as the situation demands
Qualification
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Required
2+ years working for hospitals or payers in a similar capacity
Proficient in medical terminology and knowledge of commercial insurance
Average Microsoft Excel skills required
Microsoft Excel
Microsoft Office
Confidentiality - adheres to patient rights: provides for the confidential treatment of all communications and records.
Professionalism - demonstrates professionalism with families, visitors, physicians, co-workers and supervisors.
Communication - listens and communicates effectively
Teamwork - supports teamwork by cooperative problem solving through participation in meetings, projects, etc.
Quality/ Performance Improvement - utilizes principles of continuous quality improvement in all work situations to assess, measure and improve organizational and department functions
Autonomy - organizes work sets priorities with a minimum of supervision and seeks guidance as appropriate
Accountability - makes decisions that are timely and consistent with department, objectives, policies and procedures.
Ownership - demonstrates sound judgment; accepts and benefits from constructive criticism
Analyzes and researches denials, follows-up with the payer to resolve denials
Reviews applicable timeframes governing the appeal process
Contacts appropriate third party for outcome of clinical appeal
Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal)
Documents accurately and timely the follow-up requirement on denials
Maximize utilization of Contract Management tools and efficient use of existing resources to support cash collection activities
Exercise judgment pertaining to highly sensitive and confidential information
Understanding of claims processing
Demonstrated ability to work independently and on a team as the situation demands
Preferred
Associate's degree in business or finance preferred
Benefits
Paid Time Off (PTO)
Medical and Prescription Drug Insurance
Dental and Vision Insurance
Retirement Plans
Short & Long Term Disability
Life & Accidental Death Insurance
Tuition Reimbursement
Health Care/Dependent Care Flexible Spending Accounts
Wellness Programs
Voluntary Benefits (e.g., Pet Insurance)
Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!
Company
RWJBarnabas Health
RWJBarnabas Health (RWJBH) is the largest, most comprehensive academic health care system in N.J., with a service area covering eight counties with five million people.
10,001+ employees
Funding
Current Stage
Late StageTotal Funding
$0.23MKey Investors
New Jersey Food Security Initiative
2024-07-02Grant· $0.23M
Leadership Team
Anthony Cava
President and CEO
Jordan Ruch
Chief Technology Officer
Recent News
2024-04-05
Company data provided by crunchbase
