Managed Care Appeals Analyst

Job Summary

A company is looking for a Managed Care Appeals Analyst to research and appeal underpayment amounts from payors.

Key Responsibilities

• Review closed $0 balance accounts for appropriate contractual reimbursement
• Create detailed appeals for underpayments and contact payors for clarification
• Monitor payments for accuracy and document outcomes in accordance with procedures

Required Qualifications, Training, and Education

• Associate or bachelor's degree in a relevant field or equivalent work experience
• Minimum of one year of healthcare-related experience in auditing
• 4+ years of experience in revenue cycle, hospital reimbursement, and appeals writing
• Proficient knowledge of reimbursement methodologies and medical billing terminology
• Basic understanding of HIT systems and billing applications