MissoulaRecruiter
the smart solution for Missoula jobs

Appeals Coding Specialist

Company: Allegiance
Location: Missoula
Posted on: May 13, 2019

Job Description:

Do you want a career where you can make a difference? Allegiance is a growing company with hometown values that is looking for dynamic candidates to join the team! A positive, team-oriented environment is provided with opportunities for advancement. Allegiance offers full-time positions with evenings, weekends, and holidays off and a multi-faceted benefits package. We pride ourselves in having a reputation for top-notch customer service. Make a difference. Start your career with Allegiance today! REPORTS TO: Appeals Supervisor LOCATION: Missoula FLSA STATUS: Non-Exempt POSITION RESPONSIBILITIES: The Appeals Support Specialist is responsible for providing support to the appeals processing team under the direction of the Appeals Supervisor. Primary responsibilities include assembling coding edit provider reviews and appeals, cross-referencing coding edits on claims with nationalized standards, and archiving all completed appeals and provider reviews. The incumbent is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and to be respectful and courteous in the conduct of this position. ESSENTIAL JOB FUNCTIONS: Essential job functions include the following. Other functions may be assigned as business conditions change. * Assemble appropriate documentation for new coding edit provider reviews and appeals. * Compile coding edit provider reviews/appeals in the correct order, create corresponding record in log and maintain changes, and form the appropriate PDF naming convention. * Understand and use coding manuals, NCCI standards, Medicare Correct Coding Guideline, and claims processing/company standards to research firing edits and determine if applied appropriately. * Assist Customer Service Representatives/Claims Examiners when providers call to ask about a Zelis edit * Monitor Response Sent folder, complete the finalization details in the electronic log for all completed appeal and provider reviews to identify outcome, and archive PDF in appropriate I drive files. * Email examiners to advise of outcome when a provider review is overturned and a response letter will not be issued. * Highly adaptable to take on new and additional tasks based on business needs. * Ensures quality standards and timelines are achieved. * Complies with all privacy and confidentiality laws in the course of business. * Contributes to the daily workflow with regular and punctual attendance NON-ESSENTIAL JOB FUNCTIONS: * Performs related or other assigned duties as required or directed. SUPERVISION EXERCISED: None. PHYSICAL WORKING CONDITIONS: Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Sitting 90% Reaching Some Standing 5% Manual Dexterity Medium Walking 5% Telephone Yes Kneeling Some Computer Screen High (visual acuity corrected to 20/30) Bending Some Lifting up to 20 lbs. JOB SPECIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum Education: High school graduation or GED required. Certification(s) Required: None. Minimum Experience: Experience with computers required. Prior experience with Adobe Acrobat, the full version, is desirable. Other Qualifications: Excellent oral and written communication skills required. PC skills, including Windows, Word, and Excel. Must be able to adapt to software changes as they occur. Ability to learn all functions of the claims processing software program as is necessary for report generation and adapt to software changes as they occur. Some knowledge of legal and medical terminology preferred. Ability to enter data with accuracy and precision. Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents and regulations. Proofreading and editing skills. Ability to prioritize work assignments and meet deadlines. Ability to take initiative. High level of interpersonal skills to work effectively with others. Ability to organize and recall large amounts of information including interactions with employees, agents, plan participants and clients. Ability to project a professional image and positive attitude in any work environment. Ability to comply with privacy and confidentiality standards. Ability to analyze and solve problems with professionalism and patience, and to exercise good judgment when making decisions. Ability to operate typical office equipment. Working knowledge of general office procedures. The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.SDL2017

Keywords: Allegiance, Missoula , Appeals Coding Specialist, Other , Missoula, Montana

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Get New Painting Work Today - Preview Leads In Your Area
Description: Over 25 million homeowners have trusted HomeAdvisor 1800Contractor to help them find quality professionals with the expertise to turn their home improvement
Company: HomeAdvisor
Location: Missoula
Posted on: 05/22/2019

Get New Landscaping Work Today - Preview Leads In Your Area
Description: Over 25 million homeowners have trusted HomeAdvisor 1800Contractor to help them find quality professionals with the expertise to turn their home improvement
Company: HomeAdvisor
Location: Missoula
Posted on: 05/22/2019

Teach Science in the UK from September 2019!
Description: Science teachers in the USA have a wonderful opportunity to join a UK government funded science teacher program called Quantum Scholars where science teachers receive incredible support, additional training (more...)
Company: Academics LTD
Location: Missoula
Posted on: 05/23/2019


Real Estate - Licensed Associate Needed
Description: Finding the right real estate brokerage to build your career is one of the most important decisions you will make. It is imperative you align yourself with a company that can provide you the best opportunity (more...)
Company: Keller Williams Realty
Location: Missoula
Posted on: 05/22/2019

hairdresser
Description: hairdresser Stylist At Great Clips, we know that stylists like you are most happy when they're cutting hair, so at a Great Clips salon, that's exactly what you get to do Want to be
Company: Great Clips, Inc.
Location: Missoula
Posted on: 05/22/2019

Real Estate - Licensed Associates Only
Description: Finding the right real estate brokerage to build your career is one of the most important decisions you will make. It is imperative you align yourself with a company that can provide you the best opportunity (more...)
Company: Keller Williams Realty
Location: Missoula
Posted on: 05/22/2019

Email Marketing Processor
Description: Find over 5,000 Pre-screened Work At Home Job Openings Please take the time to visit our pre-screened
Company: Mommy Jobs Online
Location: Missoula
Posted on: 05/22/2019

Medical Transcription
Description: We have a few openings for full-time HIM MTs on the 2nd and 3rd shifts. These positions would be Monday through Friday and would work every 3rd weekend both Saturday and Sunday . When working your weekend (more...)
Company: Mommy Jobs Online
Location: Missoula
Posted on: 05/22/2019

hairdresser
Description: Stylist At Great Clips, we know that stylists like you are most happy when they're cutting hair, so at a Great Clips salon, that's exactly what you get to do Want to be the best stylist in
Company: Great Clips, Inc.
Location: Missoula
Posted on: 05/22/2019

Wait Staff
Description: Overview br br The Server performs guest service in the dining room by making sure that all dining room guests are seated at clean and properly set up tables, that all guests receive prompt attention, (more...)
Company: Cracker Barrel Old Country Stores
Location: Missoula
Posted on: 05/23/2019

Log In or Create An Account

Get the latest Montana jobs by following @recnetMT on Twitter!

Missoula RSS job feeds